Great Plains Dental Specialists, PC
Dentist, Periodontics in Omaha, NE. Organization (NPI-2).
NPI number1669834693
StatusActive
Last updated in NPPESMar 29, 2016
Details
- NPI
- 1669834693
- Entity type
- Organization (NPI-2)
- Legal business name
- Great Plains Dental Specialists, PC
- Organization subpart
- No
- Enumeration date
- Mar 29, 2016
- Last updated
- Mar 29, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | – | – | Yes |
Practice location
615 N 90th StOmaha, NE 68114-2821
Phone 402-330-4100 · Fax 402-330-4103
Mailing address
615 N 90th StOmaha, NE 68114-2821
Phone 402-330-4100 · Fax 402-330-4103
Authorized official
Robert Cline
President/Owner
4023304100
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