Organization
NORTHEAST FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE GALL (OFFICE ADMINISTRATOR)
(402) 904-6005
Entity
Organization
Contact information
Practice address
1719 N COTNER BLVD, LINCOLN, NE 68505-1356
(402) 420-7045
Mailing address
1719 N COTNER BLVD, LINCOLN, NE 68505-1356
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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