Summit Dental Health - Blondo LLC

NPI #1124418892 in Omaha, Nebraska

Provider Information

NPI Number
1124418892
Entity Type
Organization
Organization Name
Summit Dental Health - Blondo LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Feb 2, 2015
Last Updated
Feb 2, 2015

Practice Location

Address
2005 N 90TH ST
City
Omaha
ZIP Code
68134-6002
Phone
(402) 799-1016

Authorized Official

Name
COREZ LOGAN
Title
CREDENTIALING SPECIALIST
Phone
(502) 254-8500

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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