Organization
SA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LIGHTFOOT (AUTHORIZED OFFICIAL)
(214) 702-0708
Entity
Organization
Contact information
Practice address
14450 EAGLE RUN DR STE 290, OMAHA, NE 68116-1493
(402) 964-9009
Mailing address
15660 DALLAS PKWY STE 950, DALLAS, TX 75248-3309
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
01/28/2026
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