| NPI | 1841598588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD RAY GAVRON President 505-988-7356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NM DD1602) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2011-03-04 |