Provider Demographics
NPI:1902463458
Name:CAPEHART PAPIO, LLC
Entity Type:Organization
Organization Name:CAPEHART PAPIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:D
Authorized Official - Last Name:DWORAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-885-8990
Mailing Address - Street 1:2110 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-6405
Mailing Address - Country:US
Mailing Address - Phone:402-885-8990
Mailing Address - Fax:
Practice Address - Street 1:10955 CUMBERLAND DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046
Practice Address - Country:US
Practice Address - Phone:402-885-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental