| NPI | 1194897058 |
|---|---|
| Doing Business As | PINE LAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | EDWARD E. QUINCY President 402-447-6042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 6834) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 4467) |
| 1223G0001X Dentist, General Practice (Licence: NE 5838) | |
| 1223G0001X Dentist, General Practice (Licence: NE 5962) | |
| 1223G0001X Dentist, General Practice (Licence: NE 5954) | |
| 1223G0001X Dentist, General Practice (Licence: NE 3376) | |
| 1223G0001X Dentist, General Practice (Licence: NE 5746) | |
| 1223G0001X Dentist, General Practice (Licence: NE 3530) | |
| 1223G0001X Dentist, General Practice (Licence: NE 6365) | |
| 1223G0001X Dentist, General Practice (Licence: NE 4543) | |
| 1223G0001X Dentist, General Practice (Licence: NE 5343) | |
| 1223G0001X Dentist, General Practice (Licence: NE 6759) | |
| 1223G0001X Dentist, General Practice (Licence: 6837) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2009-07-06 |