| NPI | 1952623902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MICHAEL RAKES Owner 402-895-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 4879) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 6712) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 6335) | |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |