NPI | 1881086809 |
---|---|
Entity Type | Organization |
Authorized Contact | DALE C. MAYFIELD President 575-392-7565 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223E0200X Dentist, Endodontics |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
Enumeration Date | 2015-02-27 |
Last Update Date | 2017-04-06 |