# MOBILE DENTAL CARE OF NEBRASKA LLC

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

## Provider details

- **NPI number:** 1144621996
- **Authorized official:** DELIA RITTER (CREDENTIALING MANAGER)
- **Authorized official phone:** (502) 244-2441

## Contact information

- **Practice address:** 2525 S 135TH AVE, OMAHA, NE 68144-2424
- **Practice address phone:** (502) 244-2441
- **Practice address fax:** (502) 254-4069
- **Mailing address:** 12910 SHELBYVILLE RD STE 300, LOUISVILLE, KY 40243-2404
- **Mailing address phone:** (502) 244-2441
- **Mailing address fax:** (502) 254-4069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 124Q00000X | Dental Hygienist | — | — | — |

## Other

- **Enumeration date:** 09/11/2014
- **Last updated:** 02/02/2017