Shadow Ridge Dental

NPI #1073811014 in Elkhorn, Nebraska

Provider Information

NPI Number
1073811014
Entity Type
Organization
Organization Name
Shadow Ridge Dental
Primary Specialty
Dentist - General Practice
Enumeration Date
Feb 28, 2011
Last Updated
Feb 28, 2011

Practice Location

Address
19103 MASON PLZ
ZIP Code
68022-5659
Phone
(402) 933-0525

Authorized Official

Name
JAMES W BECKER, DDS
Title
OWNER
Phone
(402) 933-0525

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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