Healthcare Provider Details

I. General information

NPI: 1356029920
Provider Name (Legal Business Name): CHRISTINE ISABELLA ALDER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE ISABELLA SCANLAN DDS

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CAMPUS LOOP S
LINCOLN NE
68583-1530
US

IV. Provider business mailing address

3101 CRESCENT DR APT 315
LINCOLN NE
68516-1076
US

V. Phone/Fax

Practice location:
  • Phone: 402-472-1333
  • Fax:
Mailing address:
  • Phone: 308-631-1834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7903
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: