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19013 Oakmont Dr Omaha NE 68136-4345 | |
| (804) 575-3320 | |
| (804) 575-3324 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 19013 Oakmont Dr, Omaha, Nebraska |
| Authorized Official Name and Position | Cemyira Mcdougal (CRED COORDINATOR) |
| Authorized Official Contact | 2177648609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15884 Hull Street Rd Chesterfield VA 23832-2178 Ph: (804) 575-3320 | 19013 Oakmont Dr Omaha NE 68136-4345 Ph: (804) 575-3320 |
| NPI Number | 1124848254 |
|---|---|
| Provider Enumeration Date | 10/14/2024 |
| Last Update Date | 10/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124848254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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