| NPI | 1568686228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER I. CASAUS Owner 505-822-0664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1768) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2016-04-12 |