| NPI | 1861298184 |
|---|---|
| Doing Business As | SOUTH OMAHA DENTIST |
| Entity Type | Organization |
| Authorized Contact | JESSICA HEREK Office Manager 402-331-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-19 |