| NPI | 1811288699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISE K. PICK Owner/President 505-982-0094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM 1607) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |