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18015 Oak St Suite A Omaha NE 68130-6093 | |
| (402) 763-4929 | |
| (402) 502-5990 |
| Full Name | |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 18015 Oak St, Omaha, Nebraska |
| Authorized Official Name and Position | Jacob Lee Fimple (PRESIDENT) |
| Authorized Official Contact | 4027634929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
18015 Oak St Suite A Omaha NE 68130-6093 Ph: (402) 763-4929 | 18015 Oak St Suite A Omaha NE 68130-6093 Ph: (402) 763-4929 |
| NPI Number | 1154570745 |
|---|---|
| Provider Enumeration Date | 09/18/2008 |
| Last Update Date | 09/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154570745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 6675 (Nebraska) | Primary |
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