Organization
NORTHWEST DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT RISING (MEMBER)
(701) 799-6453
Entity
Organization
Contact information
Practice address
5200 N 91ST AVE, OMAHA, NE 68134-2749
(402) 572-7677
Mailing address
27330 W CENTER RD, WATERLOO, NE 68069-6814
(701) 799-6453
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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