Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 7696 | NE |
NPI | 1023544467 |
---|---|
Provider Name | Tomasz Czechura |
First Address | Lincoln, NE 68520-1498 |
Second Address | Lincoln, NE 68506-3745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2017 |
Last Update Date | 28/07/2021 |