| NPI | 1902059397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIBBY ANN LASHLEY Clinic Coordinator 308-534-1289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 6207) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 6094) |
| 1223G0001X Dentist, General Practice (Licence: NE 4669) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2008-10-29 |