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Organization

DREGALLA FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHRISTINE DREGALLA DDS (OWNER)
(402) 385-3188
Entity
Organization

Contact information

Practice address
402 MAIN ST, PENDER, NE 68047
(402) 385-3188
(402) 385-0165
Mailing address
402 MAIN ST, PO BOX 146, PENDER, NE 68047
(402) 385-3188
(402) 385-0165

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100-257-690-00
NE
05
100-257-691-00
NE
Enumeration date
11/04/2016
Last updated
11/04/2016
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