| NPI | 1740662709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET R. BURRIS President 575-522-1983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NM 1551) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |