| NPI | 1639663792 |
|---|---|
| Doing Business As | ISHAM DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL SCOTT ISHAM Owner/Dentist 505-881-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD4733) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-06-21 |