# NORTHEAST LINCOLN FAMILY DENTISTRY LLC

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

## Provider details

- **NPI number:** 1518539493
- **Authorized official:** SUZANNE R NANTKES (HR MANAGER)
- **Authorized official phone:** (402) 309-0483

## Contact information

- **Practice address:** 8521 EXPRESS DRIVE, LINCOLN, NE 68507
- **Practice address phone:** (402) 890-8000
- **Practice address fax:** (531) 500-5129
- **Mailing address:** 8521 EXPRESS DRIVE, LINCOLN, NE 68507
- **Mailing address phone:** (402) 890-8000
- **Mailing address fax:** (531) 500-5129

## Taxonomy

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

## Other

- **Enumeration date:** 07/12/2021
- **Last updated:** 07/12/2021