Healthcare Provider Details

I. General information

NPI: 1407947427
Provider Name (Legal Business Name): SCOTT KUGLER DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 MERIDIAN
COZAD NE
69130
US

IV. Provider business mailing address

729 MERIDIAN
COZAD NE
69130
US

V. Phone/Fax

Practice location:
  • Phone: 308-784-4600
  • Fax: 308-784-4601
Mailing address:
  • Phone: 308-784-4600
  • Fax: 308-784-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5143
License Number StateNE

VIII. Authorized Official

Name: MR. SCOTT KENNETH KUGLER
Title or Position: OWNER
Credential: DDS
Phone: 308-784-4600