Individual
JAKE DOUGLAS FISHER
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
855 N 82ND PLZ, APT 8, OMAHA, NE 68114-3591
(308) 530-9516
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7316
NE
Other
Enumeration date
07/12/2016
Last updated
12/08/2016
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