Provider Demographics
NPI:1609952969
Name:LOSEKE, ELIZABETH A (DDS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:LOSEKE
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 1:3720 AVE. A, SUITE A
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847
Mailing Address - Country:US
Mailing Address - Phone:308-234-4564
Mailing Address - Fax:308-234-4566
Practice Address - Street 1:3720 AVE. A, SUITE A
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847
Practice Address - Country:US
Practice Address - Phone:308-234-4564
Practice Address - Fax:308-234-4566
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-30
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE57331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice