| NPI | 1881021236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ERICKSON WESTOVER Dentist 575-437-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NM D3694) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: NM D3814) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |