Individual
MOLLY BODENDORFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2410 S 73RD ST, OMAHA, NE 68124-2395
(402) 819-4977
Mailing address
365 N HALSTED ST APT 902, CHICAGO, IL 60661-1374
(316) 655-3731
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
021.003036
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7768
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2016
Last updated
10/13/2023
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