| NPI | 1205361342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW THOMAS MCGUIRE Owner 402-490-6690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA DDS09150) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |