Miboca 1 LLC

NPI #1043818438 in Omaha, Nebraska

Provider Information

NPI Number
1043818438
Entity Type
Organization
Organization Name
Miboca 1 LLC
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Oct 16, 2020
Last Updated
Oct 16, 2020

Practice Location

Address
5305 S 96TH ST
City
Omaha
ZIP Code
68127-3317
Phone
(402) 331-0701

Authorized Official

Name
RAFAELA MONICA ROMERO
Title
MANAGER
Phone
(402) 331-0701

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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