Organization
PIONEER WOODS DENTAL LLC
Active
Other names
Pioneer Woods Dental
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD EUGENE QUINCY DDS (MANAGER)
(402) 447-6042
Entity
Organization
Contact information
Practice address
4210 PIONEER WOODS DRIVE, SUITE D, LINCOLN, NE 68506
(402) 484-6042
(402) 484-6043
Mailing address
POB 87, 314 N 4TH ST, NEWMAN GROVE, NE 68758-0087
(402) 447-6042
(402) 447-6009
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5876
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025209600
—
NE
Enumeration date
11/15/2006
Last updated
08/22/2020
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