| NPI | 1689084311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONRAD PARKS President 402-469-4386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KS 61078) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2014-05-02 |