# AET NICHOLAS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790464477
- **Authorized official:** BRENT J RISING (MANAGER)
- **Authorized official phone:** (701) 799-6453

## Contact information

- **Practice address:** 10020 NICHOLAS ST STE 201, OMAHA, NE 68114-2188
- **Practice address phone:** (402) 614-2024
- **Mailing address:** 27330 W CENTER RD, WATERLOO, NE 68069-6814
- **Mailing address phone:** (701) 361-4560

## Taxonomy

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

## Other

- **Enumeration date:** 07/11/2023
- **Last updated:** 07/11/2023