| NPI | 1467901405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE DAVID SMITH Member 402-250-9097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NE 7206) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-03 |