Individual
LOUIS M HEDLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4940 NORMAL BLVD, LINCOLN, NE 68506-6316
(402) 486-1200
(402) 486-1317
Mailing address
6901 S 66TH ST, LINCOLN, NE 68516-3663
(402) 421-7080
(402) 486-1317
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4741
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078869213
—
NE
01
—
470788692241
DELTA PROVIDER NUMBER
—
01
—
5783
BCBS PROVIDER NUMBER
—
01
—
727208
UNITED CONCORDIA PROVIDER
—
Enumeration date
03/21/2007
Last updated
07/09/2007
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