| NPI | 1760651277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA REDMAN Secretary/Treasure 505-753-2230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1421) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |