| NPI | 1205015039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN R BUSH President/Owner 308-237-3479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 5333) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 6551) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2008-04-20 |