NPI | 1336548106 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW DAVID ANDERSON Organizer 402-972-7751 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2014012737) |
Enumeration Date | 2014-08-18 |
Last Update Date | 2014-08-18 |