Wilderness Station Pediatric Dentistry

LBN: Wilderness Station Pediatric Dentistry
Wilderness Station Pediatric Dentistry is an health care organization with primary practice located at 8020 S 13Th St , Lincoln NE 68512-9371. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Wilderness Station Pediatric Dentistry can be contacted via phone (402) 420-8020, or through Killeen, Martin D. via phone (402) 420-8020.

Contact Information

Primary practice address
8020 S 13Th St Lincoln NE 68512-9371
Phone: (402) 420-8020
Fax: (402) 420-0367
Website:
Map and Directions
Authorized official contact:
Name: Killeen, Martin D. Doctor of Dental Surgery (DDS)
Phone: (402) 420-8020

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X 6492 Nebraska

Profile Details

NPI number 1568682052
LBN Legal business name Wilderness Station Pediatric Dentistry
DBA Doing business as
Authorized official Killeen, Martin D. Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 26th, 2007
Last updated Dec 23rd, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1568682052 NPPES
Nebraska MEDICAID 10025264500

Popular Providers