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Individual

BENJAMIN ROBERT ISKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1006 MAIN ST, BRIDGEPORT, NE 69336-4035
(308) 262-1434
Mailing address
1006 MAIN STREET, BRIDGEPORT, NE 69336

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7243
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026535400
NE
Enumeration date
07/01/2014
Last updated
04/20/2016
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