Organization
PEDIATRIC DENTISTRY OF NEBRASKA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONNETTE JONES (OFFICE MANAGER)
(307) 778-7100
Entity
Organization
Contact information
Practice address
820 W 42ND ST STE 1400, SCOTTSBLUFF, NE 69361-4704
(307) 778-7100
Mailing address
1439 STILLWATER AVE STE 7, CHEYENNE, WY 82009-7367
(307) 778-7100
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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