Provider Demographics
NPI:1639368723
Name:COUNTY OF DAKOTA
Entity Type:Organization
Organization Name:COUNTY OF DAKOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-987-2164
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:DAKOTA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68731-0155
Mailing Address - Country:US
Mailing Address - Phone:402-987-2164
Mailing Address - Fax:402-987-2163
Practice Address - Street 1:1601 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DAKOTA CITY
Practice Address - State:NE
Practice Address - Zip Code:68731-0155
Practice Address - Country:US
Practice Address - Phone:402-987-2164
Practice Address - Fax:402-987-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE201001251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE087026OtherPROVIDER NUMBER