Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 113 | NE |
N | 122300000X | Dentist | 71-00-0142 | OH |
N | 1223P0700X | Prosthodontist | 113 | NE |
N | 1223P0700X | Prosthodontist | 71-00-0142 | OH |
NPI | 1083774749 |
---|---|
Provider Name | Dr. Alvin Gerard Wee |
First Address | Omaha, NE 68135-3106 |
Second Address | Omaha, NE 43210-1225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |