| NPI | 1326419540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CHARLES ROCHE Owner/Dentist 402-223-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NE 6167) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |