Organization
UNMC COLLEGE OF DENTISTRY
Active
Other names
Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL L HAACK PH.D. (ASSISTANT DEAN OF OPERATIONS)
(402) 472-3492
Entity
Organization
Contact information
Practice address
8200 DODGE ST, 2ND FLOOR SPC CHILDREN'S HOSPITAL, OMAHA, NE 68114-4113
(402) 559-6100
(402) 552-7765
Mailing address
40TH AND HOLDREGE, ROOM 2106B, LINCOLN, NE 68583-0740
(402) 472-3492
(402) 472-5290
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025084700
—
NE
05
—
2956599
—
IA
Enumeration date
10/17/2006
Last updated
12/19/2013
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