| NPI | 1043918220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL RALLIS Orthodontist 402-730-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-02-17 |
| Last Update Date | 2023-02-17 |