| NPI | 1629601877 |
|---|---|
| Former Legal Business Name | GREG SAMUELSON DDS MSD |
| Entity Type | Organization |
| Authorized Contact | KELLY MARIE WELCH FIDONE Office Manager 402-493-2268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |