Healthcare Provider Details

I. General information

NPI: 1700568052
Provider Name (Legal Business Name): AET PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/07/2023
Certification Date: 08/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18015 OAK ST STE A
OMAHA NE
68130-6097
US

IV. Provider business mailing address

18015 OAK ST STE A
OMAHA NE
68130-6097
US

V. Phone/Fax

Practice location:
  • Phone: 402-763-4929
  • Fax:
Mailing address:
  • Phone: 402-763-4929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: BRENT RISING
Title or Position: MANAGER
Credential:
Phone: 701-799-6453