# PREMIER SMILE DENTAL ASSOCIATION PC

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

## Provider details

- **NPI number:** 1942681978
- **Authorized official:** DR. STEPHANIE EBKE DDS (ASSOCIATE DENTIST)
- **Authorized official phone:** (402) 300-0506

## Contact information

- **Practice address:** 17110 LAKESIDE HILLS PLZ, OMAHA, NE 68130-5600
- **Practice address phone:** (402) 300-0506
- **Mailing address:** 56470 HIGHWAY 4, DAYKIN, NE 68338-3033
- **Mailing address phone:** (402) 300-0506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 7222 | NE | Yes |

## Other

- **Enumeration date:** 06/16/2015
- **Last updated:** 06/16/2015