| NPI | 1992091821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALE E JANCSICS Owner 505-980-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD1503) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NM DH2266) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2011-06-20 |