# MPDA MULLEN LLC

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

## Provider details

- **NPI number:** 1396630687
- **Authorized official:** TERESA CREASMAN (OFFICE MANAGER)
- **Authorized official phone:** (308) 534-1289

## Contact information

- **Practice address:** 102 SE 2ND ST, MULLEN, NE 69152-5224
- **Practice address phone:** (308) 534-1289
- **Mailing address:** 805 S MAPLE ST, NORTH PLATTE, NE 69101-5282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/09/2025
- **Last updated:** 06/09/2025