Provider Demographics
NPI:1659431369
Name:FURST, HENRY C (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:C
Last Name:FURST
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:POB 102
Mailing Address - Street 2:632 S 4TH ST
Mailing Address - City:EAGLE
Mailing Address - State:NE
Mailing Address - Zip Code:68347-0102
Mailing Address - Country:US
Mailing Address - Phone:402-781-2525
Mailing Address - Fax:
Practice Address - Street 1:632 S 4TH ST
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:NE
Practice Address - Zip Code:68347-0102
Practice Address - Country:US
Practice Address - Phone:402-781-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4538122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47060132700Medicaid