Individual
DR. ASHLEY M. TIETGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1411 J F KENNEDY DR, BELLEVUE, NE 68005-3639
(402) 291-6577
Mailing address
1411 J F KENNEDY DR, BELLEVUE, NE 68005-3639
(402) 291-6577
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DEN.00202931
CO
1223P0221X
Pediatric Dentistry
Primary
7311
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CO
Enumeration date
05/22/2015
Last updated
11/02/2020
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