| NPI | 1316203433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA L POORMAN Dentist 308-234-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NE 5646) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2012-04-03 |