| NPI | 1780744615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HUGH MASON President 505-984-1827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NM 1161) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |