Provider Demographics
NPI:1235511213
Name:KRALIK DAKOTA DENTAL, P.C.
Entity Type:Organization
Organization Name:KRALIK DAKOTA DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRALIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-372-2418
Mailing Address - Street 1:910 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NE
Mailing Address - Zip Code:68788-1002
Mailing Address - Country:US
Mailing Address - Phone:402-372-2418
Mailing Address - Fax:402-372-5060
Practice Address - Street 1:910 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NE
Practice Address - Zip Code:68788-1002
Practice Address - Country:US
Practice Address - Phone:402-372-2418
Practice Address - Fax:402-372-5060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental