Individual
GREG DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5321 CENTER ST, OMAHA, NE 68106-2338
(402) 551-2238
Mailing address
5321 CENTER ST, OMAHA, NE 68106-2338
(402) 551-2238
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4802
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160590
UNITED CONCORDIA PROVIDER
NE
01
—
5560
BCBS PROVIDER ID
NE
Enumeration date
06/30/2006
Last updated
07/08/2007
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