Organization
GENESIS ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ELLEN GLENN (BUSINESS MANAGER)
(402) 488-5275
Entity
Organization
Contact information
Practice address
7001 A ST, STE 105, LINCOLN, NE 68510-4205
(402) 488-5275
(402) 483-5200
Mailing address
7001 A STREET, SUITE 105, LINCOLN, NE 68510-4205
(402) 488-5275
(402) 483-5200
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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