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General NPI Number Information
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NPI Number | 1811000292
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Entity Type | Organization
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Legal Business Name | FAMILY DENTAL PC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 5930 SOUTH 58TH STREET SUITE E
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City | LINCOLN
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State | NE
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Zip | 68516
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Country | US
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Telephone | 402-423-9045
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Fax | 402-423-9048
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Provider Business Mailing Address
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Address Line | 5930 SOUTH 58TH STREET SUITE E
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City | LINCOLN
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State | NE
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Zip | 68516
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Country | US
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Telephone | 402-423-9045
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Fax | 402-423-9048
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Authorized Official
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Title or Position | PRESIDENT
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Name | LANCE B LINDENMUTH
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Credential | DDS
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Telephone | 402-423-9045
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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 | 5566
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License Number State | NE
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