Individual
DR. HERBERT C. COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1904 SOUTH ST, SUITE 103, BLAIR, NE 68008-1964
(402) 426-3334
(402) 426-4540
Mailing address
1904 SOUTH ST, SUITE 103, BLAIR, NE 68008-1964
(402) 426-3334
(402) 426-4540
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3849
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3849
STATE LICENSE
NE
05
—
47052774500
—
NE
Enumeration date
03/09/2007
Last updated
07/09/2007
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