| Tiburon Family Dental Pc | |
|
16919 Audrey St Suite 40 Omaha NE 68136 | |
| (402) 932-9413 | |
| (402) 505-9704 |
| Full Name | Tiburon Family Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 16919 Audrey St, Omaha, Nebraska |
| Authorized Official Name and Position | Robert H Johnson (PRESIDENT) |
| Authorized Official Contact | 4029329413 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tiburon Family Dental Pc 16919 Audrey St Suite 40 Omaha NE 68136 Ph: (402) 932-9413 | Tiburon Family Dental Pc 16919 Audrey St Suite 40 Omaha NE 68136 Ph: (402) 932-9413 |
| NPI Number | 1932214475 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932214475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6576 (Nebraska) | Primary |
| 122300000X | Dentist | 3417859922 (Utah) | Secondary |
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