Individual
KASANDRA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 N 105TH ST, OMAHA, NE 68114-1001
(402) 515-4599
Mailing address
1509 N 105TH ST, OMAHA, NE 68114-1001
(402) 515-4599
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
06/20/2025
Last updated
06/20/2025
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