Individual
MRS. ALIVIA GRACE FOCKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2714 2ND AVE STE B, KEARNEY, NE 68847-4437
(308) 455-8225
Mailing address
4503 PONY EXPRESS RD, KEARNEY, NE 68847-2565
(308) 440-1540
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7734
NE
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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