ALEXANDER DMITRY BANKETOV

OMAHA, NE
NPI1124857164
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: NE  8056)
Additional Taxonomies122300000X Dentist
(Licence: NC  13921)
Enumeration Date2024-07-29
Last Update Date2025-01-15
Business Address
ALEXANDER DMITRY BANKETOV DDS
4920 S 30TH ST STE 103
OMAHA, NE 68107-1656
Phone number: 402-734-4110
Mailing Address
ALEXANDER DMITRY BANKETOV DDS
4920 S 30TH ST STE 103
OMAHA, NE 68107-1656
Phone number: 402-734-4110
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