Individual
DR. NICHOLAS SAMUELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5118 N 156TH ST, OMAHA, NE 68116-3226
(402) 493-2268
Mailing address
5118 N 156TH ST, OMAHA, NE 68116-3226
(402) 493-2268
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DDS-09473
IA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7241
NE
Other
Enumeration date
08/20/2017
Last updated
04/12/2023
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