Organization
BELLEVUE ORAL AND MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DAVID SMITH D.D.S. (MEMBER)
(402) 250-9097
Entity
Organization
Contact information
Practice address
1004 LINCOLN RD STE 102, BELLEVUE, NE 68005-2341
(402) 250-9097
Mailing address
1004 LINCOLN RD STE 102, BELLEVUE, NE 68005-2341
(402) 250-9097
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
7206
NE
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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