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770 N Cotner Blvd Ste 202 Lincoln NE 68505-2344 | |
(402) 434-2360 | |
(402) 434-2361 |
Full Name | |
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Speciality | Clinic/Center |
Location | 770 N Cotner Blvd Ste 202, Lincoln, Nebraska |
Authorized Official Name and Position | Layusiana Ciobanu (OWNER) |
Authorized Official Contact | 4023095436 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3210 S 81st St Lincoln NE 68506-7339 Ph: (402) 309-5436 | 770 N Cotner Blvd Ste 202 Lincoln NE 68505-2344 Ph: (402) 434-2360 |
NPI Number | 1073221768 |
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Provider Enumeration Date | 11/10/2022 |
Last Update Date | 02/24/2023 |
Medicare PECOS PAC ID | 4183098692 |
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Medicare Enrollment ID | O20230324000841 |
Identifier | Type | State | Issuer |
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1073221768 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Provider Name | Layusiana Ciobanu |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1730319815 PECOS PAC ID: 7315186020 Enrollment ID: I20200625001927 |
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