Organization
GOOD LIFE DENTAL, P.C.
Active
Other names
Comprehensive Family Dentistry, L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
KATE WOLFORD WAWRZYNKIEWICZ D.D.S. (PRESIDENT)
(308) 532-0427
Entity
Organization
Contact information
Practice address
302 S BAILEY AVE, NORTH PLATTE, NE 69101-5407
(308) 532-0427
Mailing address
302 S BAILEY AVE, NORTH PLATTE, NE 69101-5407
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7079
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261QD0000X
—
NE
Enumeration date
09/23/2015
Last updated
09/23/2015
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