| NPI | 1659236875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR CUNNINGHAM Administrative Assistant 402-214-4567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-12-19 |
| Last Update Date | 2025-12-19 |