Individual
JESSICA JEANNE SOUKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
100 N 12TH ST, #502 CENTERSTONE, LINCOLN, NE 68508-1410
(402) 476-8058
Mailing address
100 N 12TH ST, #502 CENTERSTONE, LINCOLN, NE 68508-1410
(402) 476-8058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6260
NE
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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