| NPI | 1669923173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WARD Dentist 575-434-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD4468) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |