MEDICARE: APOLLO DENTAL CONSULTING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6359	NE

General Provider Information

NPI Number	:	1437525318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APOLLO DENTAL CONSULTING

Provider Business Mailing Address
First Line	:	343 N COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-2315
Country	:	US
Telephone Number	:	402-466-1914
Fax Number	:	402-475-8741

Provider Business Practice Location Address
First Line	:	343 N COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-2315
Country	:	US
Telephone Number	:	402-466-1914
Fax Number	:	402-475-8741

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CRAIG VACEK
Credential	:
Telephone Number	:	402-466-1914

Provider Enumeration Date	:	08/14/2015
Last Update Date	:	08/14/2015

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Directions to “APOLLO DENTAL CONSULTING ” Practice Location

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