Organization
SUMMIT DENTAL ASSOCIATES
Active
Other names
Rainbow Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY V STOAKES (ACCOUNT MANAGER)
(402) 884-1174
Entity
Organization
Contact information
Practice address
8041 S 83RD AVE, LAVISTA, NE 68128-2490
(402) 884-1174
(402) 884-5567
Mailing address
8041 S 83RD AVE, LAVISTA, NE 68128-2490
(402) 884-1174
(402) 884-5567
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025389000
—
NE
Enumeration date
03/03/2008
Last updated
03/03/2008
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