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Organization
RICHARD K BOKEMPER DDS PC
Active
Organization
RICHARD K BOKEMPER DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KEITH BOKEMPER DDS (PRESIDENT OWNER)
(712) 943-4242
Entity
Organization
Contact information
Practice address
703 FIRST ST, SERGEANT BLUFF, IA 51054
(712) 943-4242
(712) 943-4243
Mailing address
PO BOX 280, 703 FIRST ST, SERGEANT BLUFF, IA 51054
(712) 943-4242
(712) 943-4243
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7009
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4212770114
MEDICAID NEBRASKA
NE
05
—
IA217992
—
IA
Enumeration date
02/24/2006
Last updated
08/22/2020
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