# MOBILE HEALTH CENTER PC

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

## Provider details

- **NPI number:** 1427288042
- **Authorized official:** SHANDRA WILKINS (DIRECTOR)
- **Authorized official phone:** (402) 444-3221

## Contact information

- **Practice address:** 4737 SOUTH 96TH ST, 100, OMAHA, NE 68127
- **Practice address phone:** (402) 339-3187
- **Mailing address:** 4102 WOOLWORTH AVE, SUITE 100, OMAHA, NE 68105-1851
- **Mailing address phone:** (402) 444-3221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2009
- **Last updated:** 08/09/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025450000 | — | NE |
| 05 | — | 10025882700 | — | NE |
| 05 | — | 10025902200 | — | NE |