Organization
PEDIATRIC DENTAL SPECIALISTS OF GREATER NEBRASKA - OMAHA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID F JOHNSON III (PRACTICE ADMINISTRATOR)
(402) 397-3377
Entity
Organization
Contact information
Practice address
2410 S 73RD ST STE 203, OMAHA, NE 68124-2395
(402) 397-3377
Mailing address
2410 S 73RD ST STE 203, OMAHA, NE 68124-2395
(402) 397-3377
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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