| NPI | 1881437457 |
|---|---|
| Doing Business As | SANDIA PARK FAMILY DENTISTRY |
| Doing Business As | COPPER CANYON FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SETH STOCKTON Member 505-888-3392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |