| NPI | 1174704712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY L BAKER President 402-463-3088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NE 22775) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2007-11-26 |