| Southroads Dental &/or Dream Dental Care | |
|
712 Fort Crook Rd N Bellevue NE 68005-4558 | |
| (402) 733-6066 | |
| (402) 733-0899 |
| Full Name | Southroads Dental &/or Dream Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 712 Fort Crook Rd N, Bellevue, Nebraska |
| Authorized Official Name and Position | Robert Frazier Colwell (PRESIDENT/OWNER) |
| Authorized Official Contact | 4027336066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southroads Dental &/or Dream Dental Care 712 Fort Crook Rd N Bellevue NE 68005-4558 Ph: (402) 733-6066 | Southroads Dental &/or Dream Dental Care 712 Fort Crook Rd N Bellevue NE 68005-4558 Ph: (402) 733-6066 |
| NPI Number | 1629354667 |
|---|---|
| Provider Enumeration Date | 10/21/2011 |
| Last Update Date | 01/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629354667 | NPI | - | NPPES |
| 10025204800 | Medicaid | NE | |
| 15558428003 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6236 (Nebraska) | Primary |
| 261QD0000X | Clinic/center - Dental | 8073 (Iowa) | Secondary |
Aesthetic & Family Dentistry:cameron Larry A Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 Cornhusker Rd Ste 102, Bellevue, NE 68005 Phone: 402-293-1234 Fax: 402-293-9364 | |
Dunlow Orthodontics, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2219 Capehart Road, Suite 102, Bellevue, NE 68123 Phone: 402-934-8858 | |
Dr. Richard A Stacey Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 Betz Rd, Bellevue, NE 68005 Phone: 402-291-3721 Fax: 402-291-7566 | |
Plattsmouth Family Dentistry, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2110 Towne Center Dr, Bellevue, NE 68123 Phone: 402-885-8990 | |
David R. Mack, Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11536 S 31st St, Bellevue, NE 68123 Phone: 402-291-4468 Fax: 402-933-2014 | |
Willow Dental Bellevue, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7511 S 36th St, Bellevue, NE 68147 Phone: 402-733-2281 Fax: 918-235-9079 | |
My Pediatric Dentist Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1411 J F Kennedy Dr, Bellevue, NE 68005 Phone: 402-291-6577 |