Pine Ridge Dental Pc | |
5140 S 56th St Lincoln NE 68516-1832 | |
(402) 423-1100 | |
Not Available |
Full Name | Pine Ridge Dental Pc |
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Speciality | Dentist |
Location | 5140 S 56th St, Lincoln, Nebraska |
Authorized Official Name and Position | Richard Nolte (DENTIST/OWNER) |
Authorized Official Contact | 4024231100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pine Ridge Dental Pc 5140 S 56th St Lincoln NE 68516-1832 Ph: (402) 423-1100 | Pine Ridge Dental Pc 5140 S 56th St Lincoln NE 68516-1832 Ph: (402) 423-1100 |
NPI Number | 1194803262 |
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Provider Enumeration Date | 11/02/2006 |
Last Update Date | 11/18/2024 |
Medicare PECOS PAC ID | 8729519129 |
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Medicare Enrollment ID | O20241009000191 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194803262 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (Nebraska) | Primary |
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