Provider Demographics
NPI:1528393113
Name:CENTRE PLACE DENTAL, P.C.
Entity Type:Organization
Organization Name:CENTRE PLACE DENTAL, P.C.
Other - Org Name:CENTRE PLACE DENTAL - YORK
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:POST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-499-6633
Mailing Address - Street 1:5206 DEER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:NE
Mailing Address - Zip Code:68347-7018
Mailing Address - Country:US
Mailing Address - Phone:402-499-6633
Mailing Address - Fax:
Practice Address - Street 1:622 N BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-3030
Practice Address - Country:US
Practice Address - Phone:402-362-3222
Practice Address - Fax:402-362-2240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRE PLACE DENTAL, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental