# ADVANCED ENDODONTIC THERAPY, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Endodontic Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154570745
- **Authorized official:** DR. JACOB LEE FIMPLE D.D.S., M.M.S.C. (PRESIDENT)
- **Authorized official phone:** (402) 763-4929

## Contact information

- **Practice address:** 18015 OAK ST, SUITE A, OMAHA, NE 68130-6093
- **Practice address phone:** (402) 763-4929
- **Practice address fax:** (402) 502-5990
- **Mailing address:** 18015 OAK ST, SUITE A, OMAHA, NE 68130-6093
- **Mailing address phone:** (402) 763-4929
- **Mailing address fax:** (402) 502-5990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 6675 | NE | Yes |

## Other

- **Enumeration date:** 09/18/2008
- **Last updated:** 09/18/2008