| NPI | 1750531091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMON MOISES ORTIZ Owner 402-659-6617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DD2908) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NM DD2903) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |