Healthcare Provider Details

I. General information

NPI: 1497508923
Provider Name (Legal Business Name): SBM DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 S 62ND ST
LINCOLN NE
68516-3560
US

IV. Provider business mailing address

11725 VANDERVIEW RD
HICKMAN NE
68372-9701
US

V. Phone/Fax

Practice location:
  • Phone: 402-202-9777
  • Fax:
Mailing address:
  • Phone: 402-202-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRENT E MURPHY
Title or Position: DDS/OWNER
Credential: DDS
Phone: 402-202-9777