| Summit Dental Health - Blondo Llc | |
|
2005 N 90th St Omaha NE 68134-6002 | |
| (402) 799-1016 | |
| (402) 513-2745 |
| Full Name | Summit Dental Health - Blondo Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2005 N 90th St, Omaha, Nebraska |
| Authorized Official Name and Position | Corez Logan (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5022548500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Dental Health - Blondo Llc Po Box 437169 Louisville KY 40253-7169 Ph: (502) 254-8500 | Summit Dental Health - Blondo Llc 2005 N 90th St Omaha NE 68134-6002 Ph: (402) 799-1016 |
| NPI Number | 1124418892 |
|---|---|
| Provider Enumeration Date | 02/02/2015 |
| Last Update Date | 02/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124418892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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