Dworak, Jeff D

Dworak, Jeff D is an sole proprietor health care provider with primary practice located at 2110 Towne Center Dr , Bellevue NE 68123-6405. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Dworak, Jeff D can be contacted via phone (402) 885-8990.

Contact Information

Primary practice address
2110 Towne Center Dr Bellevue NE 68123-6405
Phone: (402) 885-8990
Fax: (402) 885-8991
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6313 Nebraska

Profile Details

NPI number 1588799407
LBN Legal business name Dworak, Jeff D
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2007
Last updated May 20th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588799407 NPPES
Nebraska Other 202172111 TAX ID#
Nebraska Other 6313 TAX ID#
Nebraska Other 1345421 TAX ID#
Nebraska Other 05248 TAX ID#
Nebraska MEDICAID 10025239900 TAX ID#

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