| Aet Dodge, LLC | |
|
15750 W Dodge Frontage Rd #303 Omaha NE 68118 | |
| (402) 763-4929 | |
| Not Available |
| Full Name | Aet Dodge, LLC |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 15750 W Dodge Frontage Rd, Omaha, Nebraska |
| Authorized Official Name and Position | Brent Rising (MANAGER) |
| Authorized Official Contact | 7017996453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aet Dodge, LLC 15750 W Dodge Frontage Rd #303 Omaha NE 68118 Ph: (402) 763-4929 | Aet Dodge, LLC 15750 W Dodge Frontage Rd #303 Omaha NE 68118 Ph: (402) 763-4929 |
| NPI Number | 1235812215 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 08/08/2023 |
| Certification Date | 08/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235812215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | () | Primary |
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