Individual
DR. ETHAN EDMINSTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4400 EMILE ST, OMAHA, NE 68198-0600
(402) 559-6000
Mailing address
113 S 38TH ST APT 255, COUNCIL BLUFFS, IA 51501-3386
(505) 702-4431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4987
NM
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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