Organization

Drsgm Llc

May also be knows as Treehouse Pediatric Dentistry

Pediatric Dentist in Gretna, NE(View on Map)

Legal Business Name

Drsgm Llc

Also Known As

Treehouse Pediatric Dentistry

NPI Number

1053185702

NPI Type

Organization

Enumeration Date

11/13/2023

Specialties

(Taxonomies)

Code

1223P0221X
261QD0000X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

10520 S 204TH ST STE C
10520 S 204TH ST STE C

City

Gretna
Gretna

State

NE
NE

Postal Code

68028-4185
68028-4185

Country

US
US

Telephone Number

(402) 403-6007
(402) 403-6007

Authorized Official

Name

Dr. Shayna Mattox

Title or Position

OWNER

Telephone Number

(402) 319-6688

Identifiers

Identifier

10029073600

Identifier State

NE

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/13/2024

Provider Address