Organization
CHIDREN'S DENTISTRY OF SOUTH OMAHA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDALENA EVANS (SR CREDENTIALING SPECIALIST)
(720) 603-4800
Entity
Organization
Contact information
Practice address
2424 OAK ST, OMAHA, NE 68105-3727
(402) 932-5553
(402) 932-5557
Mailing address
2424 OAK ST, OMAHA, NE 68105-3727
(402) 932-5553
(402) 932-5557
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/23/2012
Last updated
10/14/2024
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