| NPI | 1962532184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M. CORNALI President 505-828-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NM 1396) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |