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11229 W Dodge Rd Omaha NE 68154-2617 | |
| (402) 593-9911 | |
| (402) 593-0595 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 11229 W Dodge Rd, Omaha, Nebraska |
| Authorized Official Name and Position | Chris Harold Lippold (DENTIST) |
| Authorized Official Contact | 4025939911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11229 W Dodge Rd Omaha NE 68154-2617 Ph: (402) 593-9911 | 11229 W Dodge Rd Omaha NE 68154-2617 Ph: (402) 593-9911 |
| NPI Number | 1821226812 |
|---|---|
| Provider Enumeration Date | 06/29/2009 |
| Last Update Date | 06/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821226812 | NPI | - | NPPES |
| 0560516 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5416 (Nebraska) | Primary |
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