# THEODORE J BOLAMPERTI, LLC

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

## Provider details

- **NPI number:** 1881727485
- **Authorized official:** DR. THEODORE JAMES BOLAMPERTI DDS (DENTIST)
- **Authorized official phone:** (402) 339-3366

## Contact information

- **Practice address:** 4864 S 96TH ST, OMAHA, NE 68127-2048
- **Practice address phone:** (402) 339-3366
- **Mailing address:** 4864 S 96TH ST, OMAHA, NE 68127-2048
- **Mailing address phone:** (402) 339-3366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4854 | NE | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020