| NPI | 1679867899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET RICHARDSON Office Manager 575-627-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD2615) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |