| Husker Dental Pc | |
|
8710 N 30th St Omaha NE 68112-1810 | |
| (402) 451-7407 | |
| Not Available |
| Full Name | Husker Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 8710 N 30th St, Omaha, Nebraska |
| Authorized Official Name and Position | Jaya Maniktala (PRESIDENT) |
| Authorized Official Contact | 4024517407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Husker Dental Pc 8710 N 30th St Omaha NE 68112-1810 Ph: (402) 451-7407 | Husker Dental Pc 8710 N 30th St Omaha NE 68112-1810 Ph: (402) 451-7407 |
| NPI Number | 1063897825 |
|---|---|
| Provider Enumeration Date | 07/22/2015 |
| Last Update Date | 07/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063897825 | NPI | - | NPPES |
| 10026420100 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6791 (Nebraska) | Primary |
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