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Organization

RED WILLOW DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFF BLOMSTEDT DDS (OWNER)
(308) 345-5416
Entity
Organization

Contact information

Practice address
521 NORRIS AVE, MC COOK, NE 69001-2005
(308) 345-5416
(308) 345-5484
Mailing address
PO BOX 98, MC COOK, NE 69001-0098
(308) 345-5416
(308) 345-5484

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
09/15/2021
Last updated
09/15/2021
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