| NPI | 1912212804 |
|---|---|
| Former Legal Business Name | MONTCLAIR DENTAL ASSOCIATES, PC |
| Entity Type | Organization |
| Authorized Contact | DAVID SCOTT OLSON Owner 402-333-5337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 6849) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 4081) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2012-03-13 |