| Omaha Oral Surgery, Llc | |
|
5040 So 153rd St Omaha NE 68137-5067 | |
| (507) 316-2205 | |
| Not Available |
| Full Name | Omaha Oral Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 5040 So 153rd St, Omaha, Nebraska |
| Authorized Official Name and Position | Chase A Pruitt (OWNER) |
| Authorized Official Contact | 5073162205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omaha Oral Surgery, Llc 5040 So 153rd St Omaha NE 68137-5067 Ph: (507) 316-2205 | Omaha Oral Surgery, Llc 5040 So 153rd St Omaha NE 68137-5067 Ph: (507) 316-2205 |
| NPI Number | 1326402470 |
|---|---|
| Provider Enumeration Date | 04/05/2016 |
| Last Update Date | 04/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326402470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 28850 (Nebraska) | Primary |
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