Organization
SOUTH LINCOLN DENTAL LLC
Active
Parent organization
SOUTH LINCOLN DENTAL LLC
Other names
Williamsburg Dental - South Street
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH LINCOLN DENTAL LLC
Authorized official
BONNIE L GALL (CLINICAL COORDINATOR)
(402) 904-6005
Entity
Organization
Contact information
Practice address
1265 S COTNER BLVD, LINCOLN, NE 68510-4975
(402) 904-6005
(402) 904-6005
Mailing address
WILLIAMSBURG DENTAL SOUTH STREET, 6930 L STREET SUITE B, LINCOLN, NE 68510
(402) 904-6005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7178
NE
Other
Enumeration date
08/25/2017
Last updated
03/17/2018
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