| NPI | 1477947976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES D. ELLIS Owner/Manager 402-333-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NE 6920) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |