# COTTONWOOD DENTAL LLC

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

## Provider details

- **NPI number:** 1699005124
- **Authorized official:** RACHEL L BROWN MCDONALD DDS (OWNER)
- **Authorized official phone:** (308) 382-1890

## Contact information

- **Practice address:** 3327 W CAPITAL AVE, GRAND ISLAND, NE 68803-1334
- **Practice address phone:** (308) 382-1890
- **Practice address fax:** (308) 381-4997
- **Mailing address:** 3327 W CAPITAL AVE, GRAND ISLAND, NE 68803-1334
- **Mailing address phone:** (308) 382-1890
- **Mailing address fax:** (308) 381-4997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3813 | NE | — |
| 122300000X | Dentist | 4294 | NE | — |
| 122300000X | Dentist | 7101 | NE | Yes |
| 124Q00000X | Dental Hygienist | 2418 | NE | — |
| 124Q00000X | Dental Hygienist | 933 | NE | — |

## Other

- **Enumeration date:** 01/06/2010
- **Last updated:** 11/16/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4294 | DENTIST | NE |