Provider Demographics
NPI:1275790651
Name:NEIBAUER DENTAL CARE
Entity Type:Organization
Organization Name:NEIBAUER DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-548-4018
Mailing Address - Street 1:5630 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6641
Mailing Address - Country:US
Mailing Address - Phone:540-548-4018
Mailing Address - Fax:888-527-6297
Practice Address - Street 1:5630 PLANK RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6641
Practice Address - Country:US
Practice Address - Phone:540-548-4018
Practice Address - Fax:888-527-6297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty