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Organization
ADVANCED ORAL SURGERY, PLLC
Active
Organization
ADVANCED ORAL SURGERY, PLLC
Active
Other names
Council Bluffs Oral Surgery, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTNEY WIEMER (PRACTICE ADMINISTRATOR)
(402) 934-8999
Entity
Organization
Contact information
Practice address
3265 S 24TH ST, COUNCIL BLUFFS, IA 51501-6901
(402) 934-8999
Mailing address
5040 S 153RD ST, OMAHA, NE 68137-5067
(402) 934-8999
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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