Healthcare Provider Details

I. General information

NPI: 1851220172
Provider Name (Legal Business Name): DAVID CITY DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1877 N 4TH ST
DAVID CITY NE
68632-2209
US

IV. Provider business mailing address

1877 N 4TH ST
DAVID CITY NE
68632-2209
US

V. Phone/Fax

Practice location:
  • Phone: 402-367-3000
  • Fax:
Mailing address:
  • Phone: 402-367-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: HEATH JOSEPH KETTELER
Title or Position: OWNER
Credential: DDS
Phone: 402-367-3000