| NPI | 1831980473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDON R PETERSON Owner 402-330-9564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-05-14 |