| NPI | 1932643038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE HANNA Owner 575-993-5032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM dd4651) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2022-08-30 |