| NPI | 1912183849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN R PHIPPS President/Dentist 505-836-0322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1420) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-01-09 |