Organization
PEDIATRIC DENTAL GROUP, PC
Active
Other names
My Pediatric Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN THOMAS HAJEK D.D.S. (OWNER)
(605) 354-7077
Entity
Organization
Contact information
Practice address
1411 J F KENNEDY DR, BELLEVUE, NE 68005-3639
(402) 291-6577
Mailing address
1411 JFK DRIVE, BELLEVUE, NE 68005-0011
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7030
NE
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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