Organization
MY PEDIATRIC DENTIST WEST MAPLE PC
Active
Other names
MY PEDIATRIC DENTIST
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN HAJEK (OWNER)
(605) 354-7077
Entity
Organization
Contact information
Practice address
14270 W MAPLE RD, OMAHA, NE 68164-2436
(402) 491-3100
Mailing address
3351 N 125TH ST, OMAHA, NE 68164-4288
(605) 354-7077
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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