Organization
TIBURON FAMILY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT H JOHNSON DDS (PRESIDENT)
(402) 932-9413
Entity
Organization
Contact information
Practice address
16919 AUDREY ST, SUITE 40, OMAHA, NE 68136
(402) 932-9413
(402) 505-9704
Mailing address
16919 AUDREY ST, SUITE 40, OMAHA, NE 68136
(402) 932-9413
(402) 505-9704
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3417859922
UT
122300000X
Dentist
Primary
6576
NE
Other
Enumeration date
08/21/2006
Last updated
08/22/2020
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