| NPI | 1194244939 |
|---|---|
| Other Name | FRED LEROY HEALTH AND WELLNESS CENTER DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | LARRY VOEGELE Chief Executive Officer 402-438-9222 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-07-21 |