| NPI | 1558456368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY BARONE Office Manager 575-623-4161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DD1910) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-05-14 |