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Individual

MRS. MARIA TANCHULING NOSWORTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
900 W MISSION AVE, BELLEVUE, NE 68005-3945
(402) 291-5842
(402) 291-1621
Mailing address
838 HIDDEN HILLS DR, BELLEVUE, NE 68005-2738
(402) 291-5485

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6669
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025186200
NE
Enumeration date
03/29/2007
Last updated
07/08/2007
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