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Individual

DR. AMY TANEL CHADWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
16909 LAKESIDE HILLS PLZ, STE 111, OMAHA, NE 68130-4654
(402) 884-1828
(402) 505-9791
Mailing address
16909 LAKESIDE HILLS PLZ, STE 111, OMAHA, NE 68130-4654
(402) 884-1828
(402) 505-9791

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6417
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05273
BCBS PROVIDER ID
NE
05
100252469-00
NE
Enumeration date
09/19/2005
Last updated
10/24/2008
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