| Pine Ridge Dental Pc | |
|
5140 S 56th St Lincoln NE 68516-1832 | |
| (402) 423-1100 | |
| Not Available |
| Full Name | Pine Ridge Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 5140 S 56th St, Lincoln, Nebraska |
| Authorized Official Name and Position | Richard Nolte (DENTIST/OWNER) |
| Authorized Official Contact | 4024231100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Ridge Dental Pc 5140 S 56th St Lincoln NE 68516-1832 Ph: (402) 423-1100 | Pine Ridge Dental Pc 5140 S 56th St Lincoln NE 68516-1832 Ph: (402) 423-1100 |
| NPI Number | 1194803262 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 11/18/2024 |
| Medicare PECOS PAC ID | 8729519129 |
|---|---|
| Medicare Enrollment ID | O20241009000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194803262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Nebraska) | Primary |
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