MEDICARE: DR. CATHERINE DIANE SEAGREN ALLEY DDS MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	5576	NE

General Provider Information

NPI Number	:	1578662797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE DIANE SEAGREN ALLEY DDS MS

Provider Business Mailing Address
First Line	:	1217 NORTH COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-1837
Country	:	US
Telephone Number	:	402-466-6700
Fax Number	:	402-466-6700

Provider Business Practice Location Address
First Line	:	1217 NORTH COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-1837
Country	:	US
Telephone Number	:	402-466-6700
Fax Number	:	402-466-6700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/09/2023

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