Organization
SMILES 4 KIDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDALENA EVANS (SR CREDENTIALING SPECIALIST)
(720) 603-4763
Entity
Organization
Contact information
Practice address
7631 CASS STREET, OMAHA, NE 68114-3623
(402) 393-0594
Mailing address
7631 CASS STREET, OMAHA, NE 68114-3623
(402) 393-0594
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7002
NE
Other
Enumeration date
08/21/2012
Last updated
10/14/2024
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