Organization
PARRA FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODENE EDMONDS (DENTAL MANAGER)
(402) 731-5423
Entity
Organization
Contact information
Practice address
5050 L STREET, OMAHA, NE 68117
(402) 731-5423
(402) 884-5955
Mailing address
5050 L STREET, OMAHA, NE 68117
(402) 731-5423
(402) 884-5955
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NE
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025130200
—
NE
05
—
10025602000
—
NE
Enumeration date
11/07/2006
Last updated
09/04/2013
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