Organization
FREMONT CHILDREN'S DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT ROTHE D.D.S (OWNER)
(402) 727-8700
Entity
Organization
Contact information
Practice address
1947 E MILITARY AVE, FREMONT, NE 68025-5467
(402) 727-8700
(402) 727-8705
Mailing address
1947 E MILITARY AVE, FREMONT, NE 68025-5467
(402) 727-8700
(402) 727-8705
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025787600
—
NE
Enumeration date
02/23/2012
Last updated
02/23/2012
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