Organization
PONCA FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE A FENDRICK DDS (OWNER)
(402) 755-2291
Entity
Organization
Contact information
Practice address
213 EAST STREET, PONCA, NE 68770-0658
(402) 755-2291
(402) 755-2292
Mailing address
213 EAST STREET, PO BOX 658, PONCA, NE 68770-0658
(402) 755-2291
(402) 755-2292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7008
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025084300
—
NE
Enumeration date
04/17/2014
Last updated
04/17/2014
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