| Parra Family Dentistry Pc | |
|
5050 L Street Omaha NE 68117 | |
| (402) 731-5423 | |
| (402) 884-5955 |
| Full Name | Parra Family Dentistry Pc |
|---|---|
| Speciality | Dentist |
| Location | 5050 L Street, Omaha, Nebraska |
| Authorized Official Name and Position | Jodene Edmonds (DENTAL MANAGER) |
| Authorized Official Contact | 4027315423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parra Family Dentistry Pc 5050 L Street Omaha NE 68117 Ph: (402) 731-5423 | Parra Family Dentistry Pc 5050 L Street Omaha NE 68117 Ph: (402) 731-5423 |
| NPI Number | 1396814182 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 09/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396814182 | NPI | - | NPPES |
| 10025130200 | Medicaid | NE | |
| 10025602000 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Nebraska) | Secondary |
| 122300000X | Dentist | (* (Not Available)) | Primary |
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