NPI | 1982412904 |
---|---|
Entity Type | Organization |
Authorized Contact | GIA HUY LE Member 505-718-1140 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2024-12-23 |
Last Update Date | 2025-02-10 |