Individual
DR. MICAH TODD JEPPESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10274 S 71ST ST, PAPILLION, NE 68133
(402) 339-2501
(402) 339-2503
Mailing address
10274 S 71ST ST, PAPILLION, NE 68133
(402) 339-2501
(402) 339-2503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6101
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47083321900
—
NE
Enumeration date
12/13/2006
Last updated
09/02/2016
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