Organization Name: | DAVID E. JANDA, D.D.S.,P.C. |
NPI Number: | 1053445254 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID E. JANDA (PRESIDENT) |
Mailing Address: | 2009 W Faidley Ave Grand Island |
State: | NE US |
Postal Code: | 688034644 |
Phone Number: | 3083828677 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |