| NPI | 1639616139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW R. MCDONALD Owner 505-828-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD4636) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |