Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 5109 | NE |
NPI | 1003985318 |
---|---|
Provider Name | Dr. Joseph Anthony Ramirez |
First Address | Omaha, NE 68131-2218 |
Second Address | Omaha, NE 68144-3969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
470740803-13 | (05) | NE |