Healthcare Provider Details

I. General information

NPI: 1578934519
Provider Name (Legal Business Name): NEBRASKA SMILES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 10/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9006 OHIO ST SUITE 3
OMAHA NE
68134-6139
US

IV. Provider business mailing address

9006 OHIO ST SUITE 3
OMAHA NE
68134-6139
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-4443
  • Fax:
Mailing address:
  • Phone: 402-397-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL W. MORRISON
Title or Position: OWNER
Credential: DDS, MSD
Phone: 402-595-0717