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General NPI Number Information
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NPI Number | 1831214279
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Entity Type | Organization
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Legal Business Name | ANTELOPE CREEK FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 4940 NORMAL BLVD
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City | LINCOLN
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State | NE
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Zip | 68506-6316
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Country | US
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Telephone | 402-486-1200
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Fax | 402-486-1317
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Provider Business Mailing Address
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Address Line | 4940 NORMAL BLVD
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City | LINCOLN
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State | NE
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Zip | 68506-6316
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Country | US
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Telephone | 402-486-1200
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Fax | 402-486-1317
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICKI L TREAT
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Credential | D.D.S.
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Telephone | 402-421-1905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4741
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4874
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License Number State | NE
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