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Individual

MICHAEL J KNOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS PC

Contact information

Practice address
115 E 2ND ST, OGALLALA, NE 69153-2533
(308) 284-2961
(308) 284-0845
Mailing address
115 E 2ND ST, OGALLALA, NE 69153-2533
(308) 284-2961
(308) 284-0845

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5890
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05737
BLUE CROSS BLUE SHIELD
NE
Enumeration date
10/17/2005
Last updated
08/12/2011
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