Individual
KILEY MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDH
Contact information
Practice address
215 N PEARL ST, WAYNE, NE 68787-1975
(402) 375-2200
Mailing address
57052 HIGHWAY 59, LAUREL, NE 68745-1971
(402) 841-3694
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2779
NE
Other
Enumeration date
12/03/2019
Last updated
11/27/2023
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