Organization
MOBILE HEALTH CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANDRA WILKINS (DIRECTOR)
(402) 444-3221
Entity
Organization
Contact information
Practice address
4737 SOUTH 96TH ST, 100, OMAHA, NE 68127
(402) 339-3187
Mailing address
4102 WOOLWORTH AVE, SUITE 100, OMAHA, NE 68105-1851
(402) 444-3221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025450000
—
NE
05
—
10025882700
—
NE
05
—
10025902200
—
NE
Enumeration date
07/16/2009
Last updated
08/09/2011
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