| NPI | 1558746099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH CRAIG COOMBS Orthodontist/Owner 575-640-3367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD4079) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-10-13 |