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NPI Code Detail

MEDICARE: HARRIS OBERMILLER LLC

MEDICARE: HARRIS OBERMILLER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1023387743
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARRIS OBERMILLER LLC
Provider Business Mailing Address
First Line : 1003 W 3RD ST
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-5831
Country : US
Telephone Number : 308-382-0110
Fax Number : 308-382-8504
Provider Business Practice Location Address
First Line : 1003 W 3RD ST
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-5831
Country : US
Telephone Number : 308-382-0110
Fax Number : 308-382-8504
Authorized Official
Title or Position : PRACTICE MANAGER
Name : KATIE JO KUCK
Credential :
Telephone Number : 308-382-0110
Provider Enumeration Date : 12/27/2011
Last Update Date : 12/27/2011

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Directions to “HARRIS OBERMILLER LLC ” Practice Location

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