| NPI | 1023491297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN LANE COMBS Owner 308-631-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CO DEN.00006022) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2019-02-05 |