Individual
ELLIE NICOLE PETERSEN-BURKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8200 DODGE ST, OMAHA, NE 68114-4113
(402) 559-6100
Mailing address
19467 U ST, OMAHA, NE 68135-4210
(402) 429-4016
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8098
NE
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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