| NPI | 1720144967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP TRACY BRIGDEN President 402-393-1108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 5969) |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2020-08-22 |