# BOLAMPERTI FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043534340
- **Authorized official:** SHERRY DIXON (OFFICE MANAGER)
- **Authorized official phone:** (402) 330-2007

## Contact information

- **Practice address:** 14801 W CENTER RD, OMAHA, NE 68144-3298
- **Practice address phone:** (402) 330-2007
- **Practice address fax:** (402) 330-2594
- **Mailing address:** 14801 W CENTER RD, OMAHA, NE 68144-3298
- **Mailing address phone:** (402) 330-2007
- **Mailing address fax:** (402) 330-2594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3748 | NE | — |
| 1223G0001X | General Practice Dentistry | 4481 | NE | Yes |
| 1223G0001X | General Practice Dentistry | 6749 | NE | — |

## Other

- **Enumeration date:** 03/16/2010
- **Last updated:** 03/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025648800 | — | NE |
| 05 | — | 47049503201 | — | NE |
| 05 | — | 47058325901 | — | NE |