| NPI | 1609014521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CHARLES KERSCHEN Dentist/President 505-898-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM 2545) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2010-06-10 |