| NPI | 1629072954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN DANA President 402-330-5913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 6047) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 6514) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 3441) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 5175) | |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2008-07-31 |