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General NPI Number Information
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NPI Number | 1275778227
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Entity Type | Organization
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Legal Business Name | HOLDREGE FAMILY DENTAL, L.L.C
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 01/06/2014
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Provider Practice Location Address
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Address Line | 130 W 14TH AVE
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City | HOLDREGE
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State | NE
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Zip | 68949-1270
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Country | US
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Telephone | 308-995-8666
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Fax | 308-995-2759
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Provider Business Mailing Address
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Address Line | PO BOX 408
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City | HOLDREGE
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State | NE
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Zip | 68949-0408
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Country | US
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Telephone | 308-995-8666
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Fax | 308-995-2759
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS J. NELSEN
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Credential | D.D.S
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Telephone | 308-995-8666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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