Doctor Name: | DENNIS M CONNOLLY |
NPI Number: | 1760584387 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 13830 |
Business Practice Address: | 3910 Village Dr Lincoln, NE - 685164783 |
Business Phone Number: | 4024347383 |
Business Fax Number: | 4024347382 |
Mailing Address: | 8055 O St, Ste 300 LINCOLN |
State: | NE |
Postal Code: | 685102580 |
Phone Number: | 4024210896 |
Fax Number: | 4024210945 |
NPI Enumeration Date: | 09/03/2006 |
NPI Last Update Date: | 02/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13830 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |