| Tooth Fairy Pc | |
|
121 E 31st St Kearney NE 68847-3001 | |
| (308) 234-5437 | |
| (308) 234-3169 |
| Full Name | Tooth Fairy Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 121 E 31st St, Kearney, Nebraska |
| Authorized Official Name and Position | Teresa L Poorman (DENTIST) |
| Authorized Official Contact | 3082345437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth Fairy Pc 121 E 31st St Kearney NE 68847-3001 Ph: (308) 234-5437 | Tooth Fairy Pc 121 E 31st St Kearney NE 68847-3001 Ph: (308) 234-5437 |
| NPI Number | 1316203433 |
|---|---|
| Provider Enumeration Date | 04/03/2012 |
| Last Update Date | 04/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316203433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 5646 (Nebraska) | Primary |
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