| NPI | 1760254577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SWANGER Practice Manager 402-651-6430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2023-10-25 |