Individual
DR. SAMUEL DUDLEY BOTTARO II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH, DPH
Contact information
Practice address
9701 S 26TH AVE, BELLEVUE, NE 68123-4407
(402) 651-2413
Mailing address
9701 S 26TH AVE, BELLEVUE, NE 68123-4407
(402) 651-2413
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
12328
OK
183500000X
Pharmacist
18954
IA
183500000X
Pharmacist
Primary
8331
NE
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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