Cottonwood Dental LLC
Dentist in Grand Island, NE. Organization (NPI-2).
NPI number1699005124
StatusActive
Last updated in NPPESNov 16, 2023
Details
- NPI
- 1699005124
- Entity type
- Organization (NPI-2)
- Legal business name
- Cottonwood Dental LLC
- Organization subpart
- No
- Enumeration date
- Jan 6, 2010
- Certification date
- Nov 16, 2023
- Last updated
- Nov 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 7101 | NE | Yes |
| 122300000X | Dentist | 3813 | NE | |
| 124Q00000X | Dental Hygienist | 933 | NE | |
| 124Q00000X | Dental Hygienist | 2418 | NE | |
| 122300000X | Dentist | 4294 | NE |
Practice location
3327 W Capital AveGrand Island, NE 68803-1334
Phone 308-382-1890 · Fax 308-381-4997
Mailing address
3327 W Capital AveGrand Island, NE 68803-1334
Phone 308-382-1890 · Fax 308-381-4997
Authorized official
Rachel L Brown McDonald
Owner
3083821890
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