Healthcare Provider Details

I. General information

NPI: 1114008943
Provider Name (Legal Business Name): MONTE K ZYSSET DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7555 S 57TH ST SUITE 1
LINCOLN NE
68516-6663
US

IV. Provider business mailing address

7555 S 57TH ST SUITE 1
LINCOLN NE
68516-6663
US

V. Phone/Fax

Practice location:
  • Phone: 402-423-7171
  • Fax: 402-423-7274
Mailing address:
  • Phone: 402-423-7171
  • Fax: 402-423-7274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number6203
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: