| Fort Theatre Dentistry | |
|
2205 Central Ave Kearney NE 68847-5346 | |
| (308) 237-5853 | |
| (308) 237-5089 |
| Full Name | Fort Theatre Dentistry |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2205 Central Ave, Kearney, Nebraska |
| Authorized Official Name and Position | Walter D Martin (OWNER) |
| Authorized Official Contact | 3082375853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Theatre Dentistry 2205 Central Ave Kearney NE 68847-5346 Ph: (308) 237-5853 | Fort Theatre Dentistry 2205 Central Ave Kearney NE 68847-5346 Ph: (308) 237-5853 |
| NPI Number | 1568670537 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568670537 | NPI | - | NPPES |
| 100252764-00 | Medicaid | NE |
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