# SOUTH OMAHA DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Spring Valley Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881608156
- **Authorized official:** DR. FRANK NORMAN VARON D.D.S. (OWNER)
- **Authorized official phone:** (402) 733-4441

## Contact information

- **Practice address:** 5360 S 72ND ST, RALSTON, NE 68127-2876
- **Practice address phone:** (402) 733-4441
- **Practice address fax:** (402) 733-5863
- **Mailing address:** 5360 S 72ND ST, RALSTON, NE 68127-2876
- **Mailing address phone:** (402) 733-4441
- **Mailing address fax:** (402) 733-5863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5826 | NE | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 06/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 470080530100 | — | NE |
| 01 | — | 5530 | NE BCBS | NE |