Healthcare Provider Details

I. General information

NPI: 1962615468
Provider Name (Legal Business Name): JOSEPH JAMES HURD DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 S 84TH STREET
PAPILLION NE
68046
US

IV. Provider business mailing address

8900 S 84TH STREET
PAPILLION NE
68046
US

V. Phone/Fax

Practice location:
  • Phone: 402-339-0506
  • Fax: 402-339-3287
Mailing address:
  • Phone: 402-339-0506
  • Fax: 402-339-3287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4136
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: