Provider First Line Business Practice Location Address:
40TH & HOLDREGE STREET
Provider Second Line Business Practice Location Address:
ORTHODONTIC DEPARTMENT
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68583-0740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-296-1045
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2013