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Organization

HUSKER DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAYA MANIKTALA DDS (PRESIDENT)
(402) 451-7407
Entity
Organization

Contact information

Practice address
8710 N 30TH ST, OMAHA, NE 68112-1810
(402) 451-7407
Mailing address
8710 N 30TH ST, OMAHA, NE 68112-1810
(402) 451-7407

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6791
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026420100
NE
Enumeration date
07/22/2015
Last updated
07/22/2015
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