Individual
DR. MATTHEW JOSEPH SEVERIN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5826 S 147TH ST, OMAHA, NE 68137-2538
(402) 895-4555
Mailing address
5826 S 147TH ST, OMAHA, NE 68137-2538
(402) 895-4555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5567
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47071622400
—
NE
Enumeration date
10/19/2005
Last updated
07/08/2007
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