Organization
MIBOCA 3 LLC
Active
Other names
South Omaha Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HEREK (OFFICE MANAGER)
(402) 331-0701
Entity
Organization
Contact information
Practice address
2002 VINTON ST, OMAHA, NE 68108-1921
(531) 777-2546
Mailing address
2002 VINTON ST, OMAHA, NE 68108-1921
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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