| NPI | 1699068411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON RODNEY WILCOX Dentist/Owner 308-762-6131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 6926) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2012-06-18 |