Provider Demographics
NPI:1427181197
Name:SONDEREGGER, KURT W (DDS)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:W
Last Name:SONDEREGGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 A ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4510
Mailing Address - Country:US
Mailing Address - Phone:402-477-3355
Mailing Address - Fax:402-477-1198
Practice Address - Street 1:3255 A ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4510
Practice Address - Country:US
Practice Address - Phone:402-477-3355
Practice Address - Fax:402-477-1198
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE43431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice