| NPI | 1831423177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM PATRICK KELSEY Owner 402-934-4745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NE 6632) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |