Healthcare Provider Details

I. General information

NPI: 1578662797
Provider Name (Legal Business Name): CATHERINE DIANE SEAGREN ALLEY DDS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 NORTH COTNER BLVD
LINCOLN NE
68505-1837
US

IV. Provider business mailing address

1217 NORTH COTNER BLVD
LINCOLN NE
68505-1837
US

V. Phone/Fax

Practice location:
  • Phone: 402-466-6700
  • Fax: 402-466-6700
Mailing address:
  • Phone: 402-466-6700
  • Fax: 402-466-6700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number5576
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: