| NPI | 1770597627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BINGHAM Owner/President 505-256-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD2035) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |