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General NPI Number Information
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NPI Number | 1609506187
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Entity Type | Organization
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Legal Business Name | ALLISON HURLBUT DDS LLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 5611 NW 1ST ST STE 108
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City | LINCOLN
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State | NE
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Zip | 68521-4466
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Country | US
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Telephone | 402-438-5588
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Fax | 402-438-5715
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Provider Business Mailing Address
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Address Line | 17455 PRAIRIE VISTA DR
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City | ROCA
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State | NE
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Zip | 68430
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Country | US
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Telephone | 402-499-5279
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON CHRISTINE HURLBUT
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Credential | DDS
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Telephone | 402-499-5279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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