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General NPI Number Information
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NPI Number | 1386984441
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Entity Type | Organization
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Legal Business Name | GREGORY FOUGHT DDS PC
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 8600 EXECUTIVE WOODS DR SUITE 100
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City | LINCOLN
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State | NE
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Zip | 68512-9301
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Country | US
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Telephone | 402-421-8021
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Fax |
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Provider Business Mailing Address
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Address Line | 8600 EXECUTIVE WOODS DR SUITE 100
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City | LINCOLN
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State | NE
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Zip | 68512-9301
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Country | US
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Telephone | 402-421-8021
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JAMI STEVENS
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Credential |
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Telephone | 402-421-8021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 6432
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License Number State | NE
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