Organization
NELIGH FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY BROVONT (OWNER)
(402) 887-5214
Entity
Organization
Contact information
Practice address
322 M ST, NELIGH, NE 68756-1421
(402) 887-5214
Mailing address
322 M ST, NELIGH, NE 68756-1421
(402) 887-5214
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026675000
—
NE
Enumeration date
10/09/2018
Last updated
10/09/2018
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