Individual
DR. MARK THOMAS CHASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8424 W CENTER RD, SUITE 100, OMAHA, NE 68124-3138
(402) 397-1300
(402) 397-6449
Mailing address
8424 W CENTER RD, SUITE 100, OMAHA, NE 68124-3138
(402) 397-1300
(402) 397-6449
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5456
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-0736187-00
—
NE
Enumeration date
05/23/2007
Last updated
07/09/2007
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