| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 258 N 114th St, Omaha, Nebraska |
| Authorized Official Name and Position | Viktoryia Bobr (OWNER) |
| Authorized Official Contact | 5073981377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12405 Deer Creek Dr Omaha NE 68142-1684 Ph: (507) 398-1377 | 258 N 114th St Omaha NE 68154-2515 Ph: (402) 334-9239 |
| NPI Number | 1639854284 |
|---|---|
| Provider Enumeration Date | 06/21/2023 |
| Last Update Date | 08/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639854284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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