Provider Demographics
NPI:1558452813
Name:FRANCO, THEODORE STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:STEVEN
Last Name:FRANCO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2439
Mailing Address - Country:US
Mailing Address - Phone:402-614-9433
Mailing Address - Fax:
Practice Address - Street 1:5709 NW RADIAL HWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-4141
Practice Address - Country:US
Practice Address - Phone:402-551-1757
Practice Address - Fax:402-551-1517
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6434122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025274600Medicaid
NE04688OtherBCBS