| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 607 O St, Loup City, Nebraska |
| Authorized Official Name and Position | Charles S. Skoglund (OWNER) |
| Authorized Official Contact | 4026443177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
607 O St Loup City NE 68853-8003 Ph: (308) 745-1861 | 607 O St Loup City NE 68853-8003 Ph: (308) 745-1861 |
| NPI Number | 1285867671 |
|---|---|
| Provider Enumeration Date | 09/01/2009 |
| Last Update Date | 09/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285867671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |