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General NPI Number Information
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NPI Number | 1629436019
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Entity Type | Organization
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Legal Business Name | NBD LINCOLN PC
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 02/01/2016
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Provider Practice Location Address
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Address Line | 6520 HOLDREGE ST
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City | LINCOLN
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State | NE
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Zip | 68505-1655
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Country | US
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Telephone | 402-464-1861
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Fax |
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Provider Business Mailing Address
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Address Line | 6520 HOLDREGE ST
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City | LINCOLN
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State | NE
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Zip | 68505-1655
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Country | US
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Telephone | 402-464-1861
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | GREG BENNETT
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Credential |
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Telephone | 402-464-1861
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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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