| NPI | 1689876963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C MITCHELL Managing Partner 505-881-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM 02-256180-00-3) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2009-07-08 |