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General NPI Number Information
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NPI Number | 1467440313
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Entity Type | Individual
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Provider Name | JANE LAURA BENNETT DDS
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Gender | Female
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 545 FORTUNE DR SUITE 400
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City | PAPILLION
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State | NE
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Zip | 68046-3421
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Country | US
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Telephone | 402-502-1256
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Fax | 402-504-3322
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Provider Business Mailing Address
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Address Line | 545 FORTUNE DR SUITE 400
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City | PAPILLION
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State | NE
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Zip | 68046-3421
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Country | US
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Telephone | 402-502-1256
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Fax | 402-504-3322
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6410
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License Number State | NE
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