| NPI | 1376294298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN ALLEN LASHLEY Sole Member 308-534-1289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |