Healthcare Provider Details

I. General information

NPI: 1225029754
Provider Name (Legal Business Name): MATTHEW JOSEPH KUNASEK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 S 4TH ST SUITE 100
SEWARD NE
68434
US

IV. Provider business mailing address

306 S 4TH ST SUITE 100
SEWARD NE
68434
US

V. Phone/Fax

Practice location:
  • Phone: 402-643-2931
  • Fax: 402-643-4258
Mailing address:
  • Phone: 402-643-2931
  • Fax: 402-643-4258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6476
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: