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Lincoln, Nebraska

Provider NPI: 1285778431

Organization Information:
Authorized Official:  ERIC  DESHAZER  OWNER  402-4235055

Practice Location:
5500 S 56TH ST  LINCOLN, NE 68516 US
Tel: 402-423-5055  Fax: --

Business Mailing Address:
5500 S 56TH ST  LINCOLN, NE 68516 US
Tel: 402-423-5055  Fax: --

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers


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