| NPI | 1326418641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI WILCOX Financial Director 308-382-4297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE HC069) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NE HC069) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2016-08-15 |