Ponca Tribe of Nebraska

NPI #1194244939 in Omaha, Nebraska

Provider Information

NPI Number: 1194244939
Entity Type: Organization
Organization Name: Ponca Tribe of Nebraska
Subpart: Yes (part of a larger organization)
Parent Organization: PONCA TRIBE OF NEBRASKA
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Sep 13, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 2602 J ST
City: Omaha
State: Nebraska
ZIP Code: 68107-1643
Phone: (402) 733-3612

Authorized Official

Name: MR. LARRY VOEGELE
Title: CHIEF EXECUTIVE OFFICER
Phone: (402) 438-9222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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