Provider Demographics
NPI:1972823078
Name:POBANZ, CHRIS BRYNER (DDS)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:BRYNER
Last Name:POBANZ
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 1:4009 6TH AVE
Mailing Address - Street 2:SUITE 49
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2386
Mailing Address - Country:US
Mailing Address - Phone:308-236-0220
Mailing Address - Fax:
Practice Address - Street 1:4009 6TH AVE
Practice Address - Street 2:SUITE 49
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2386
Practice Address - Country:US
Practice Address - Phone:308-236-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE67061223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics