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 |