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Individual

DR. JONATHAN CALEB SAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
130 W 14TH AVE, HOLDREGE, NE 68949-1270
(308) 995-8666
(308) 995-2759
Mailing address
130 W 14TH AVE, HOLDREGE, NE 68949-1270
(308) 995-8666
(308) 995-2759

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6879
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025699000
NE
Enumeration date
06/29/2010
Last updated
07/11/2011
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