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General NPI Number Information
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NPI Number | 1407465966
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Entity Type | Organization
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Legal Business Name | PRAIRIE MEADOWS DENTAL, PC
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 1055 W 56TH ST
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City | KEARNEY
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State | NE
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Zip | 68845-8511
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Country | US
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Telephone | 308-708-7970
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Fax | 308-708-7975
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Provider Business Mailing Address
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Address Line | 1055 W 56TH ST
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City | KEARNEY
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State | NE
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Zip | 68845-8511
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Country | US
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Telephone | 308-708-7970
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Fax | 308-708-7975
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | AARON JEFFREY MADSEN
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Credential | MBA, ATC, NREMT
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Telephone | 308-708-7970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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