Healthcare Provider Details

I. General information

NPI: 1992110696
Provider Name (Legal Business Name): MOLLY E CAWLEY D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY E DOYLE

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 S 30TH ST STE 103
OMAHA NE
68107-1656
US

IV. Provider business mailing address

4920 S 30TH ST STE 103
OMAHA NE
68107-1656
US

V. Phone/Fax

Practice location:
  • Phone: 402-734-4110
  • Fax: 402-734-3990
Mailing address:
  • Phone: 402-734-4110
  • Fax: 402-734-3990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7162
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: