| NPI | 1114063443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI HACKEL Office Manager 402-498-8804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 5060) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 5248) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2008-06-12 |