Family and Cosmetic Dentistry PC

NPI #1194884296 in Omaha, Nebraska

Provider Information

NPI Number: 1194884296
Entity Type: Organization
Organization Name: Family and Cosmetic Dentistry PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 6, 2006
Last Updated: Aug 1, 2012

Practice Location

Address: 11836 ELM STREET
Address 2: SUITE 1
City: Omaha
State: Nebraska
ZIP Code: 68144-4439
Phone: (402) 334-8208

Authorized Official

Name: TIMOTHY RAY ELLIS, DDS
Title: PRESIDENT
Phone: (402) 334-8208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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