NPI | 1215960976 |
---|---|
Former Legal Business Name | FLATROCK FAMILY DENTISTRY, P.C. |
Entity Type | Organization |
Authorized Contact | DEREK PATRICK WALROD President 308-534-8080 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 6052) |
Enumeration Date | 2006-07-08 |
Last Update Date | 2009-08-12 |