NPI | 1740808211 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIELLE BORUCH Insurance Administrator 402-421-3401 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
Enumeration Date | 2020-07-10 |
Last Update Date | 2021-09-15 |