Individual
DR. HIBA A KELLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5305 S 96TH ST, OMAHA, NE 68127-3317
(402) 331-0701
(402) 331-7130
Mailing address
5305 S 96TH ST, OMAHA, NE 68127-3317
(402) 331-0701
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7118
NE
1223G0001X
General Practice Dentistry
8639
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04010443
—
CO
Enumeration date
08/09/2005
Last updated
10/08/2013
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