Individual
WESLEY D JANSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
557 MOHAWK ST, SYRACUSE, NE 68446-0336
(402) 269-2535
(402) 269-2535
Mailing address
PO BOX 336, SYRACUSE, NE 68446-0336
(402) 269-2535
(402) 269-2535
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4745
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05377
BLUE CROSS
NE
05
—
47061931400
—
NE
Enumeration date
09/12/2006
Last updated
07/08/2007
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