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 |