Organization
SOUTH LINCOLN FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE NANTKES (HUMAN RESOURCE MANAGER)
(402) 309-0483
Entity
Organization
Contact information
Practice address
2121 S. 70TH STREET, LINCOLN, NE 68506
(402) 413-7700
Mailing address
2121 S. 70TH STREET, LINCOLN, NE 68506
(402) 413-7700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6483
DENTAL LICENSE
NE
Enumeration date
05/29/2020
Last updated
05/29/2020
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