Organization
PIONEER PERIODONTICS & IMPLANT DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E RUTLDEGE DDS,MS (PERIODONTIST/OWNER)
(402) 483-7631
Entity
Organization
Contact information
Practice address
1640 S 70TH ST, STE #200, LINCOLN, NE 68506-1571
(402) 483-7631
(402) 483-1237
Mailing address
1640 S 70TH ST, STE #200, LINCOLN, NE 68506-1571
(402) 483-7631
(402) 483-1237
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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