| Waterford Dental, Llc | |
|
15450 Ida Street Suite 100 Bennington NE 68007 | |
| (701) 799-6453 | |
| Not Available |
| Full Name | Waterford Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15450 Ida Street, Bennington, Nebraska |
| Authorized Official Name and Position | Brent Rising (OWNER) |
| Authorized Official Contact | 7017996453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterford Dental, Llc 27330 W Center Rd Waterloo NE 68069-6814 Ph: (701) 799-6453 | Waterford Dental, Llc 15450 Ida Street Suite 100 Bennington NE 68007 Ph: (701) 799-6453 |
| NPI Number | 1962125492 |
|---|---|
| Provider Enumeration Date | 09/20/2022 |
| Last Update Date | 09/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962125492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Paul E Bacino Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 S Stark St, Bennington, NE 68007 Phone: 402-238-2434 Fax: 402-238-3230 |