Individual
TERESA L POORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
121 E 31ST ST, KEARNEY, NE 68847-3001
(308) 234-5437
(308) 234-3169
Mailing address
121 E 31ST ST, KEARNEY, NE 68847-3001
(308) 234-5437
(308) 234-3169
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5646
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4778072813
—
NE
Enumeration date
08/30/2006
Last updated
07/09/2007
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