Individual
DR. CHAD W. TOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4830 SAINT PAUL AVE, LINCOLN, NE 68504-2661
(402) 466-2248
(402) 466-3286
Mailing address
4830 SAINT PAUL AVE, LINCOLN, NE 68504-2661
(402) 466-2248
(402) 466-3286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6171
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4706364-55-00
—
NE
05
—
5077227600
—
NE
Enumeration date
05/09/2007
Last updated
07/09/2007
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