| NPI | 1912024027 |
|---|---|
| Doing Business As | NEW MEXICO DEPARTMENT OF HEALTH, SPECIAL NEEDS DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JIM COPELAND Ddsd Director 505-660-3453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD1302) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD3457) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2018-07-09 |