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12041 Blondo St Omaha NE 68164-3905 | |
| (402) 493-2314 | |
| (402) 614-3018 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12041 Blondo St, Omaha, Nebraska |
| Authorized Official Name and Position | Kathryn P Schneider (PRESIDENT/DENTIST) |
| Authorized Official Contact | 4024932314 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12041 Blondo St Omaha NE 68164-3905 Ph: (402) 493-2314 | 12041 Blondo St Omaha NE 68164-3905 Ph: (402) 493-2314 |
| NPI Number | 1043571482 |
|---|---|
| Provider Enumeration Date | 06/01/2012 |
| Last Update Date | 02/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043571482 | NPI | - | NPPES |
| 100258792-00 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6839 (Nebraska) | Primary |
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