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General NPI Number Information
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NPI Number | 1538243530
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Entity Type | Organization
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Legal Business Name | CENTRAL DENTAL GROUP PC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 515 WEST 9TH ST
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City | HASTINGS
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State | NE
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Zip | 68901
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Country | US
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Telephone | 402-463-0625
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Fax | 402-463-2417
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Provider Business Mailing Address
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Address Line | 515 WEST 9TH ST. P.O. BOX 787
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City | HASTINGS
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State | NE
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Zip | 68901
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Country | US
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Telephone | 402-463-0625
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Fax | 402-463-2417
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANN M. HECKMAN
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Credential | D.D.S.
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Telephone | 402-463-0625
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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 | 6358 ANN M HECKMAN
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6471 NATHAN L THOMPS
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4958 ALAN L ROBERTSO
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License Number State | NE
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