| NPI | 1780817692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. JACOB CHARTIER Orthodontist 505-891-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD2985) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |