| David J Rallis Dds Md Oral And Maxillofacial Surgery, Pc | |
|
4110 A Street Lincoln NE 68510 | |
| (402) 327-9400 | |
| (402) 327-9401 |
| Full Name | David J Rallis Dds Md Oral And Maxillofacial Surgery, Pc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 4110 A Street, Lincoln, Nebraska |
| Authorized Official Name and Position | David J Rallis (PRESIDENT/OWNER) |
| Authorized Official Contact | 5073580974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David J Rallis Dds Md Oral And Maxillofacial Surgery, Pc 4110 A Street Lincoln NE 68510 Ph: (402) 327-9400 | David J Rallis Dds Md Oral And Maxillofacial Surgery, Pc 4110 A Street Lincoln NE 68510 Ph: (402) 327-9400 |
| NPI Number | 1760708218 |
|---|---|
| Provider Enumeration Date | 04/08/2010 |
| Last Update Date | 06/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760708218 | NPI | - | NPPES |
| 10025849700 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 25504 (Nebraska) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 6487 (Nebraska) | Primary |
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