Provider Demographics
NPI:1932541018
Name:WEES & LOW ORTHODONTICS
Entity Type:Organization
Organization Name:WEES & LOW ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:402-330-3200
Mailing Address - Street 1:11414 W CENTER RD
Mailing Address - Street 2:STE #334
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4486
Mailing Address - Country:US
Mailing Address - Phone:402-330-3200
Mailing Address - Fax:402-330-1545
Practice Address - Street 1:11414 W CENTER RD
Practice Address - Street 2:STE #334
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4486
Practice Address - Country:US
Practice Address - Phone:402-330-3200
Practice Address - Fax:402-330-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE68461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE28406846Medicaid