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Organization
GOOD LIFE DENTAL, P.C.
Active
Organization
GOOD LIFE DENTAL, P.C.
Active
Other names
Comprehensive Family Dentistry, L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
KATE WOLFORD WAWRZYNKIEWICZ D.D.S. (PRESIDENT)
(308) 532-0427
Entity
Organization
Contact information
Practice address
302 S BAILEY AVE, NORTH PLATTE, NE 69101-5407
(308) 532-0427
Mailing address
302 S BAILEY AVE, NORTH PLATTE, NE 69101-5407
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7079
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261QD0000X
—
NE
Enumeration date
09/23/2015
Last updated
09/23/2015
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