# PLATTE VALLEY ORAL & MAXILLOFACIAL SURGERY LLC

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

## Provider details

- **NPI number:** 1255737078
- **Authorized official:** RYAN FOOTE (PARTNER)
- **Authorized official phone:** (308) 633-1760

## Contact information

- **Practice address:** 416 VALLEY VIEW DRIVE, SUITE 800, SCOTTSBLUFF, NC 69361-1420
- **Practice address phone:** (308) 633-1760
- **Practice address fax:** (308) 633-1762
- **Mailing address:** 416 VALLEY VIEW DRIVE, SUITE 800, SCOTTSBLUFF, NC 69361-1420
- **Mailing address phone:** (308) 633-1760
- **Mailing address fax:** (308) 633-1762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2014
- **Last updated:** 11/05/2014