# NBD NORTHWEST LLC

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

## Provider details

- **NPI number:** 1609553692
- **Authorized official:** MISSY RYAN (HUMAN RESOURCES)
- **Authorized official phone:** (605) 213-0071

## Contact information

- **Practice address:** 5200 N 91ST AVE STE B, OMAHA, NE 68134-2749
- **Practice address phone:** (402) 493-8320
- **Mailing address:** 5200 N 91ST AVE STE B, OMAHA, NE 68134-2749

## Taxonomy

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

## Other

- **Enumeration date:** 06/30/2023
- **Last updated:** 06/30/2023