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General NPI Number Information
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NPI Number | 1437525318
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Entity Type | Organization
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Legal Business Name | APOLLO DENTAL CONSULTING
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 343 N COTNER BLVD
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City | LINCOLN
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State | NE
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Zip | 68505-2315
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Country | US
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Telephone | 402-466-1914
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Fax | 402-475-8741
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Provider Business Mailing Address
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Address Line | 343 N COTNER BLVD
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City | LINCOLN
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State | NE
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Zip | 68505-2315
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Country | US
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Telephone | 402-466-1914
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Fax | 402-475-8741
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRAIG VACEK
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Credential |
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Telephone | 402-466-1914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6359
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License Number State | NE
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