| NPI | 1265776207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD ALDERMAN Dentist 402-438-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 6483) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 6889) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |