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NPI Code Detail

MEDICARE: DR. JAMA L. OBERMILLER DDS

MEDICARE: DR. JAMA L. OBERMILLER DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6361NE

General Provider Information

NPI Number : 1780726406
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMA L. OBERMILLER DDS
Provider Business Mailing Address
First Line : 4112 BUCKINGHAM DR
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-6426
Country : US
Telephone Number : 308-398-0208
Fax Number :
Provider Business Practice Location Address
First Line : 1003 W 3RD ST
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-5831
Country : US
Telephone Number : 308-382-0110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JAMA L. OBERMILLER DDS” Practice Location

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