| NPI | 1689728651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J FARRELL President 505-822-0663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM 2031) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NM 1480) |
| 1223G0001X Dentist General Practice (Licence: NM 2298) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |