| NPI | 1093458945 |
|---|---|
| Former Legal Business Name | WATERS FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JORY T CROUCH Owner/Dentist 308-380-7622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-04-19 |