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Individual

NOLAND WILLIAM BROEKEMIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
11110 FORT ST STE 106, OMAHA, NE 68164-2183
(402) 492-8300
Mailing address
3157 FARNAM ST APT 7618, OMAHA, NE 68131-3548
(308) 940-2821

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7467
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H13204619
DRIVER'S LICENSE
NE
Enumeration date
06/08/2018
Last updated
06/08/2018
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