Organization
ORAL SURGERY CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON DANIEL STINEMAN D.D.S., M.D. (OWNER/PRESIDENT)
(402) 644-4452
Entity
Organization
Contact information
Practice address
2071 33RD AVE, SUITE B, COLUMBUS, NE 68601-3178
(402) 562-5557
(402) 562-5553
Mailing address
2501 LAKERIDGE DR, SUITE 100, NORFOLK, NE 68701-2558
(402) 644-4452
(402) 644-4454
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025886100
—
NE
Enumeration date
10/25/2011
Last updated
10/25/2011
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