# KEARNEY DENTAL CLINIC P C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205015039
- **Authorized official:** DR. STEPHEN R BUSH D.D.S. (PRESIDENT/OWNER)
- **Authorized official phone:** (308) 237-3479

## Contact information

- **Practice address:** 4106 6TH AVE, KEARNEY, NE 68845-3395
- **Practice address phone:** (308) 237-3281
- **Practice address fax:** (308) 236-9642
- **Mailing address:** 4106 6TH AVE, KEARNEY, NE 68845-3395
- **Mailing address phone:** (308) 237-3479
- **Mailing address fax:** (308) 236-9642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5333 | NE | Yes |
| 1223G0001X | General Practice Dentistry | 6551 | NE | — |

## Other

- **Enumeration date:** 10/29/2007
- **Last updated:** 04/20/2008