| NPI | 1487253068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MAUREEN STILLMAN ANDERSON Owner/Dentist 402-990-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2020-10-23 |