| NPI | 1760260525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA MUNOZ Practice Manager 575-437-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-09-21 |