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 |