| NPI | 1982293189 |
|---|---|
| Doing Business As | NORTHERN NEW MEXICO CENTER FOR COSMETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CARY LACOUTURE Clinical Manager 303-521-5701 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |