Individual
JACQUELINE POWELL FICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8410 S 73RD PLZ, PAPILLION, NE 68046-1513
(402) 592-2219
Mailing address
8108 S 152ND AVE, OMAHA, NE 68138-3314
(859) 640-0559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0006817-C1
AL
1223G0001X
General Practice Dentistry
Primary
7771
NE
Other
Enumeration date
10/04/2020
Last updated
07/25/2023
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