Individual
PHILLIP TRACY BRIGDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11919 GRANT ST STE 140, OMAHA, NE 68164-3475
(402) 493-4175
(877) 811-8129
Mailing address
11919 GRANT ST STE 140, OMAHA, NE 68164-3475
(402) 493-4175
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5969
NE
1223G0001X
General Practice Dentistry
Primary
5969
NE
Other
Enumeration date
08/17/2011
Last updated
09/18/2019
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