Provider Demographics
NPI:1821321738
Name:KREJCI, JAMES RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:KREJCI
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 1:718 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:NE
Mailing Address - Zip Code:68873-2015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:718 6TH ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:NE
Practice Address - Zip Code:68873-2015
Practice Address - Country:US
Practice Address - Phone:308-754-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5343122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist