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Organization
ADVANCED ENDODONTIC THERAPY, PC
Active
Organization
ADVANCED ENDODONTIC THERAPY, PC
Active
Other names
Advanced Endodontic Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB LEE FIMPLE D.D.S., M.M.S.C. (PRESIDENT)
(402) 763-4929
Entity
Organization
Contact information
Practice address
18015 OAK ST, SUITE A, OMAHA, NE 68130-6093
(402) 763-4929
(402) 502-5990
Mailing address
18015 OAK ST, SUITE A, OMAHA, NE 68130-6093
(402) 763-4929
(402) 502-5990
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6675
NE
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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