Kennedy, Bruce Orval

Kennedy, Bruce Orval is an sole proprietor health care provider with primary practice located at 1117 Main Ave , Crete NE 68333-2259. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Kennedy, Bruce Orval can be contacted via phone (402) 826-2488.

Contact Information

Primary practice address
1117 Main Ave Crete NE 68333-2259
Phone: (402) 826-2488
Fax: (402) 826-4752
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 4325 Nebraska

Profile Details

NPI number 1871517078
LBN Legal business name Kennedy, Bruce Orval
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871517078 NPPES
Nebraska MEDICAID 47055729400

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