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13215 Birch Dr Suite 100 Omaha NE 68114 | |
| (402) 390-0770 | |
| (402) 390-1074 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 13215 Birch Dr, Omaha, Nebraska |
| Authorized Official Name and Position | Gregory J Smith (CONTROLLER) |
| Authorized Official Contact | 4023900770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13215 Birch Dr Suite 100 Omaha NE 68164-5431 Ph: (402) 390-0770 | 13215 Birch Dr Suite 100 Omaha NE 68114 Ph: (402) 390-0770 |
| NPI Number | 1760576813 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 05/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760576813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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