Provider Demographics
NPI:1669172243
Name:AFFORDABLE DENTURES & IMPLANTS - OMAHA, P.C.
Entity type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - OMAHA, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-733-8551
Mailing Address - Street 1:3602 EDGERTON DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4312
Mailing Address - Country:US
Mailing Address - Phone:402-731-0989
Mailing Address - Fax:402-731-0993
Practice Address - Street 1:3602 EDGERTON DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-4312
Practice Address - Country:US
Practice Address - Phone:402-731-0989
Practice Address - Fax:402-731-0993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty