Provider Demographics
NPI:1730972472
Name:PLATTE RIVER ORTHODONTICS LLC
Entity type:Organization
Organization Name:PLATTE RIVER ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-322-8838
Mailing Address - Street 1:11844 STANDING STONE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-8111
Mailing Address - Country:US
Mailing Address - Phone:402-322-8838
Mailing Address - Fax:
Practice Address - Street 1:11844 STANDING STONE DR STE 100
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-8111
Practice Address - Country:US
Practice Address - Phone:402-322-8838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty