Provider Demographics
NPI:1649281700
Name:OGUNLEYE, AFOLABI OLUFOLAHAN (DMD)
Entity type:Individual
Prefix:DR
First Name:AFOLABI
Middle Name:OLUFOLAHAN
Last Name:OGUNLEYE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16405 MASON ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-2729
Mailing Address - Country:US
Mailing Address - Phone:402-708-6222
Mailing Address - Fax:402-916-5800
Practice Address - Street 1:546 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2632
Practice Address - Country:US
Practice Address - Phone:402-280-5976
Practice Address - Fax:402-280-5005
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE66421223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery