| 3d Dental Pc | |
|
17853 Pierce Plaza Omaha NE 68130 | |
| (402) 614-0322 | |
| (402) 991-4608 |
| Full Name | 3d Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 17853 Pierce Plaza, Omaha, Nebraska |
| Authorized Official Name and Position | Dean D Dewispelare (OWNER PRESIDENT) |
| Authorized Official Contact | 4026140322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 3d Dental Pc 17853 Pierce Plaza Omaha NE 68130 Ph: (402) 614-0322 | 3d Dental Pc 17853 Pierce Plaza Omaha NE 68130 Ph: (402) 614-0322 |
| NPI Number | 1538172192 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538172192 | NPI | - | NPPES |
| 10025228900 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6173 (Nebraska) | Primary |
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