Individual
AUSTIN J STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 BETZ RD, BELLEVUE, NE 68005-3059
(402) 291-3721
Mailing address
1201 BETZ RD, BELLEVUE, NE 68005-3059
(402) 291-3721
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7763
NE
1223G0001X
General Practice Dentistry
DN26038
FL
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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