Individual
MACE BOGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14111 PACIFIC ST, OMAHA, NE 68154-2863
(402) 896-9112
Mailing address
14111 PACIFIC ST, OMAHA, NE 68154-2863
(402) 896-9112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7746
NE
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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