| NPI | 1558946855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH C COOMBS Owner 575-521-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-03-17 |