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2067 N 120th St Omaha NE 68164-3401 | |
| (402) 492-8626 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2067 N 120th St, Omaha, Nebraska |
| Authorized Official Name and Position | Sarah C Armstrong (OFFICE MANAGER) |
| Authorized Official Contact | 4024928626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2067 N 120th St Omaha NE 68164-3401 Ph: (402) 492-8626 | 2067 N 120th St Omaha NE 68164-3401 Ph: (402) 492-8626 |
| NPI Number | 1023068673 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023068673 | NPI | - | NPPES |
| 10025308900 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4357 (Nebraska) | Primary |
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