Provider Demographics
NPI:1093168056
Name:CATTLE, ALYSSA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:CATTLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 FLETCHER AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-5862
Mailing Address - Country:US
Mailing Address - Phone:402-413-0505
Mailing Address - Fax:
Practice Address - Street 1:2110 FLETCHER AVE STE 110
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-5862
Practice Address - Country:US
Practice Address - Phone:402-413-0505
Practice Address - Fax:402-413-0503
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7324122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist