Individual
DR. CHARLES WILLIAM GENRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4830 SAINT PAUL AVE, LINCOLN, NE 68504-2661
(402) 466-2211
(402) 466-3286
Mailing address
4830 SAINT PAUL AVE, LINCOLN, NE 68504-2661
(402) 466-2211
(402) 466-3286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5148
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-079002700
—
NE
Enumeration date
02/15/2007
Last updated
07/08/2007
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