Healthcare Provider Details

I. General information

NPI: 1417153313
Provider Name (Legal Business Name): DAVID MICHAEL BATKO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14133 Q ST
OMAHA NE
68137
US

IV. Provider business mailing address

1915 S 62ND ST
OMAHA NE
68106-2138
US

V. Phone/Fax

Practice location:
  • Phone: 402-895-1900
  • Fax: 402-895-5726
Mailing address:
  • Phone: 402-895-1900
  • Fax: 402-895-5726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6712
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: