| NPI | 1558703314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SON-STONE Executive Director 505-262-6546 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101Y00000X Counselor |
| 122300000X Dentist | |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2024-10-08 |