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General NPI Number Information
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NPI Number | 1447601976
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Entity Type | Organization
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Legal Business Name | JESSEN'S FAMILY DENTISTRY AND DENTAL HYGIENE, P.C
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 126 N 5TH STREET
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City | ONEILL
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State | NE
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Zip | 68763-0815
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Country | US
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Telephone | 402-336-4812
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Fax |
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Provider Business Mailing Address
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Address Line | 126 N 5TH STREET
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City | ONEILL
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State | NE
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Zip | 68763-0815
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Country | US
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Telephone | 402-336-4812
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JON S JESSEN
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Credential |
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Telephone | 402-336-4812
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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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