Individual
BROOKE KITTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5500 O ST, LINCOLN, NE 68510-2130
(402) 467-1000
Mailing address
5500 O ST, LINCOLN, NE 68510-2130
(402) 467-1000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7542
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7542
DENTAL LICENSE
NE
Enumeration date
09/04/2019
Last updated
09/04/2019
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