| NPI | 1972860419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT J RISING President/Owner Dds 402-496-9950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NE 5480) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NE 6819) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2015-08-11 |