Individual
DR. TIMOTHY WAYNE LEBSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2628 W 2ND ST, HASTINGS, NE 68901-4606
(402) 462-5546
(402) 462-6998
Mailing address
2628 W 2ND ST, HASTINGS, NE 68901-4606
(402) 462-5546
(402) 462-6998
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4461
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470591245-00
—
NE
Enumeration date
10/28/2006
Last updated
07/08/2007
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