Samuelson, Greg Stuart
Samuelson, Greg Stuart is an sole proprietor health care provider with primary practice located at 13808 W Maple Rd Suite 112, Omaha NE 68164-6231. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Samuelson, Greg Stuart can be contacted via phone (402) 493-2268.Contact Information
Primary practice address
13808 W Maple Rd Suite 112
Omaha NE 68164-6231
Phone: (402) 493-2268
Fax: (402) 445-8370
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 5341 | Nebraska |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 7681 | Iowa |
Profile Details
| NPI number | 1316051469 |
|---|---|
| LBN Legal business name | Samuelson, Greg Stuart |
| Credentials | D.D.S. M.S.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 18th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316051469 | NPPES |
| Nebraska | MEDICAID | 10025140300 | |
| Nebraska | MEDICAID | 1225359 |
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