Provider Demographics
NPI:1932530169
Name:LANGAN DENTAL HEALTH CENTER PC
Entity type:Organization
Organization Name:LANGAN DENTAL HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-371-3991
Mailing Address - Street 1:1010 RIVERSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2897
Mailing Address - Country:US
Mailing Address - Phone:402-371-3991
Mailing Address - Fax:402-371-2155
Practice Address - Street 1:1010 RIVERSIDE BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-2897
Practice Address - Country:US
Practice Address - Phone:402-371-3991
Practice Address - Fax:402-371-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025850200Medicaid