Healthcare Provider Details

I. General information

NPI: 1932541018
Provider Name (Legal Business Name): WEES & LOW ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11414 W CENTER RD STE #334
OMAHA NE
68144-4486
US

IV. Provider business mailing address

11414 W CENTER RD STE #334
OMAHA NE
68144-4486
US

V. Phone/Fax

Practice location:
  • Phone: 402-330-3200
  • Fax: 402-330-1545
Mailing address:
  • Phone: 402-330-3200
  • Fax: 402-330-1545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6846
License Number StateNE

VIII. Authorized Official

Name: DR. LAURA LOW
Title or Position: PRESIDENT
Credential: DDS MS
Phone: 402-330-3200