Wilderness Station Pediatric Dentistry

NPI 1568682052 - Clinic/Center - 261QD0000X

NPI Details
NPI 1568682052
Enumeration Date 04/26/2007
Last Updated 12/23/2014
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARTIN D. MARTIN
Position DOCTOR
Phone (402) 420-8020
Fax (402) 420-0367
Practice Location
8020 S 13TH ST
LINCOLN NE, 68512-9371, US
Phone (402) 420-8020
Fax (402) 420-0367
Business Location
8020 S 13TH ST
LINCOLN NE, 68512-9371, US
Phone (402) 420-8020
Fax (402) 420-0367
Toxanomy
Taxonomy Code 261QD0000X
License State Nebraska
License Number 6492
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According to our database, Wilderness Station Pediatric Dentistry NPI is 1568682052, taxonomy code is 261QD0000X and license number is 6492, license state is located at Nebraska. Wilderness Station Pediatric Dentistry physically located at 8020 S 13th St, Lincoln NE, 68512-9371. NPI Number 1033115704 has the healthcare provider type.

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1568682052 NPI number is provided on an as is basis without warranty of any kind. 1568682052 is maintained by the National Plan & Provider Enumeration System. The contents of Wilderness Station Pediatric Dentistry are for informational purposes only.