NPI | 1538638002 |
---|---|
Doing Business As | RIVERSIDE DENTAL AND BEAUTY SPA |
Entity Type | Organization |
Authorized Contact | BARBARA LEWIS-HEYWOOD Owner/Dentist 505-922-6000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2018-11-14 |
Last Update Date | 2018-11-14 |