Organization
SURF'S UP PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYCE CUSHING (OWNER/CEO)
(435) 890-2295
Entity
Organization
Contact information
Practice address
10350 S. TERRANCE, PAPILLION, NE 68133
(435) 890-2295
Mailing address
10350 S. TERRANCE, PAPILLION, NE 68133
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/18/2022
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