Provider Demographics
NPI:1144092685
Name:SEAN D. PAULEY, DDS, PC
Entity type:Organization
Organization Name:SEAN D. PAULEY, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-540-6124
Mailing Address - Street 1:8926 BROKEN SPOKE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-3403
Mailing Address - Country:US
Mailing Address - Phone:402-540-6124
Mailing Address - Fax:
Practice Address - Street 1:5930 S 58TH ST STE E
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3653
Practice Address - Country:US
Practice Address - Phone:402-423-9045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty