NPI | 1871902593 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA HODGES Operations Director 505-787-2965 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD2287) |
Enumeration Date | 2014-08-06 |
Last Update Date | 2020-10-15 |