| NPI | 1740392778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY ANN PROFAZI Owner Dental Hygienist 505-891-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NM DH1218) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |