# AMBER IDE DDS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ide Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750950937
- **Authorized official:** AMBER IDE DDS (OWNER)
- **Authorized official phone:** (308) 784-3377

## Contact information

- **Practice address:** 1002 MERIDIAN AVE, COZAD, NE 69130-1757
- **Practice address phone:** (308) 784-3377
- **Practice address fax:** (308) 784-3395
- **Mailing address:** PO BOX 147, COZAD, NE 69130-0147
- **Mailing address phone:** (308) 784-3377
- **Mailing address fax:** (308) 784-3395

## Taxonomy

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

## Other

- **Enumeration date:** 06/22/2021
- **Last updated:** 06/23/2021
