Individual
LANNAE LYNN PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
221 S JEFFERS ST, SUITE #1, NORTH PLATTE, NE 69101-5371
(308) 534-4040
(308) 534-1087
Mailing address
1121 TANNER CT, NORTH PLATTE, NE 69101-0333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6557
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025389900
—
NE
Enumeration date
10/16/2006
Last updated
08/08/2012
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