| NPI | 1609908763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL E. MIRABAL CEO 505-898-2797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |