| NPI | 1356772420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL HENRY President/Owner 402-435-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NE 18887) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NE 5504) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2013-11-27 |