| NPI | 1619197506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JOHN PADILLA Dental Director 505-827-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: NM E6603) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |