| NPI | 1992942387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK F DUVERNOIS Owner 915-581-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |