Organization
ALLIANCE DENTAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY DEE CHRISTENSEN D.D.S. (PRESIDENT)
(308) 762-6354
Entity
Organization
Contact information
Practice address
2308 BOX BUTTE AVE., ALLIANCE, NE 69301-0586
(308) 762-6354
Mailing address
PO BOX 586, ALLIANCE, NE 69301-0586
(308) 762-6354
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4498
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07862
BCBSNE
NE
05
—
10024961800
—
NE
Enumeration date
11/06/2006
Last updated
04/25/2013
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