Provider Demographics
NPI:1932370525
Name:MAPLE VIEW FAMILY DENTISTRY PC
Entity Type:Organization
Organization Name:MAPLE VIEW FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-393-3555
Mailing Address - Street 1:9006 OHIO ST STE 2
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-6139
Mailing Address - Country:US
Mailing Address - Phone:402-393-3555
Mailing Address - Fax:
Practice Address - Street 1:9006 OHIO ST STE 2
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6139
Practice Address - Country:US
Practice Address - Phone:402-393-3555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE50761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty