Organization
DENTAL MANAGEMENT SERVICES
Active
Other names
Emergency Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUN O PARKER D.D.S (MANAGER)
(402) 593-9911
Entity
Organization
Contact information
Practice address
11229 W DODGE RD, OMAHA, NE 68154-2617
(402) 593-9911
(402) 593-0595
Mailing address
11229 W DODGE RD, OMAHA, NE 68154-2617
(402) 593-9911
(402) 593-0595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4895
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0560516
—
IA
05
—
100252051-00
—
NE
Enumeration date
02/26/2007
Last updated
08/22/2020
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