Individual
DR. JOHN RICHARD PANTALONE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7333 FARNAM ST, OMAHA, NE 68114-4649
(402) 393-1931
(402) 592-2502
Mailing address
7333 FARNAM ST, OMAHA, NE 68114-4649
(402) 393-1931
(402) 592-2502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4062
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004947
BLUE CROSS/BS NUMBER
NE
05
—
061402621-00
—
NE
Enumeration date
10/25/2005
Last updated
07/09/2007
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