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General NPI Number Information
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NPI Number | 1316368384
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST DENTALASSOCCIATES OF WEST POINT, P.C.
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Dates
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Enumeration Date | 12/18/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 140 E 22ND ST STE 2
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City | FREMONT
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State | NE
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Zip | 68025-2667
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Country | US
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Telephone | 402-727-9525
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Fax |
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Provider Business Mailing Address
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Address Line | 140 E 22ND ST SUITE 2
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City | FREMONT
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State | NE
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Zip | 68025-2667
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Country | US
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Telephone | 402-727-9525
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES S SKOGLUND
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Credential |
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Telephone | 402-644-3177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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