| NPI | 1043534340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY DIXON Office Manager 402-330-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 4481) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 3748) |
| 1223G0001X Dentist, General Practice (Licence: NE 6749) | |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |