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Individual provider · Dentist · Hatch, NM
- NPI
- 1609073378
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- DD2879 (NM)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2007-06-27
- Last updated
- 2007-07-08
Practice location
255 Hwy 187
Hatch, NM 87937
(505) 267-3286