| NPI | 1730232588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HERMAN Orhtodontist 505-564-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD1859) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD1859) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2013-10-24 |