# COVARRUBIAS DENTAL LLC

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

## Provider details

- **NPI number:** 1609561208
- **Authorized official:** JOSE COVARRUBIAS (OWNER)
- **Authorized official phone:** (308) 384-7500

## Contact information

- **Practice address:** 206 WILMAR AVE STE 4, GRAND ISLAND, NE 68803-3559
- **Practice address phone:** (308) 384-7500
- **Mailing address:** PO BOX 70887, CLEVELAND, OH 44190-7088

## Taxonomy

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

## Other

- **Enumeration date:** 04/10/2023
- **Last updated:** 04/10/2023