Mark Panneton DDS PC
Clinic/Center, Dental in La Vista, NE. Organization (NPI-2).
NPI number1891069043
StatusActive
Last updated in NPPESMar 6, 2012
Details
- NPI
- 1891069043
- Entity type
- Organization (NPI-2)
- Legal business name
- Mark Panneton DDS PC
- Organization subpart
- No
- Enumeration date
- Mar 6, 2012
- Last updated
- Mar 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 5527 | NE | Yes |
Practice location
9731 Giles RdLa Vista, NE 68128-2930
Phone 402-537-4620 · Fax 402-537-4346
Mailing address
9731 Giles RdLa Vista, NE 68128-2930
Phone 402-537-4620 · Fax 402-537-4346
Authorized official
Mark J Panneton
Owner
4025374620
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