Healthcare Provider Details

I. General information

NPI: 1548244213
Provider Name (Legal Business Name): ALLEN JOSEPH HEBERT JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CAPEHART RD
OFFUTT AFB NE
68113-1043
US

IV. Provider business mailing address

2501 CAPEHART ROAD
BELLEVUE NE
68123
US

V. Phone/Fax

Practice location:
  • Phone: 402-942-8015
  • Fax:
Mailing address:
  • Phone: 937-751-7529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4487
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: