Organization
DAVID J RALLIS DDS MD ORAL AND MAXILLOFACIAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J RALLIS M.D., D.D.S. (PRESIDENT/OWNER)
(507) 358-0974
Entity
Organization
Contact information
Practice address
4110 A STREET, LINCOLN, NE 68510
(402) 327-9400
(402) 327-9401
Mailing address
4110 A STREET, LINCOLN, NE 68510
(402) 327-9400
(402) 327-9401
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
25504
NE
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
6487
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025849700
—
NE
Enumeration date
04/08/2010
Last updated
06/07/2010
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