| NPI | 1245505049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY GARCIA President 402-421-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 6771) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 5917) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |