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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