| NPI | 1760910194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT J CARRANZA Owner 308-236-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 6781) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2022-07-21 |