Organization
MARK PANNETON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J PANNETON DDS (OWNER)
(402) 537-4620
Entity
Organization
Contact information
Practice address
9731 GILES RD, LA VISTA, NE 68128-2930
(402) 537-4620
(402) 537-4346
Mailing address
9731 GILES RD, LA VISTA, NE 68128-2930
(402) 537-4620
(402) 537-4346
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5527
NE
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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