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4210 Pioneer Woods Drive Suite D Lincoln NE 68506 | |
| (402) 484-6042 | |
| (402) 484-6043 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4210 Pioneer Woods Drive, Lincoln, Nebraska |
| Authorized Official Name and Position | Edward Eugene Quincy (MANAGER) |
| Authorized Official Contact | 4024476042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Pob 87 314 N 4th St Newman Grove NE 68758-0087 Ph: (402) 447-6042 | 4210 Pioneer Woods Drive Suite D Lincoln NE 68506 Ph: (402) 484-6042 |
| NPI Number | 1912079781 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912079781 | NPI | - | NPPES |
| 10025209600 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5876 (Nebraska) | Primary |
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