Provider Demographics
NPI:1306466081
Name:VILLAGE POINTE ORAL SURGERY P.C.
Entity type:Organization
Organization Name:VILLAGE POINTE ORAL SURGERY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TOOMBS
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:402-317-5657
Mailing Address - Street 1:17121 MARCY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-3133
Mailing Address - Country:US
Mailing Address - Phone:402-317-5657
Mailing Address - Fax:402-317-5647
Practice Address - Street 1:17121 MARCY ST STE 102
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3133
Practice Address - Country:US
Practice Address - Phone:402-317-5657
Practice Address - Fax:402-317-5647
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VILLAGE POINTE ORAL SURGERY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty