Individual
DR. RICHARD JOHN VANEK SR.
Active
Individual
DR. RICHARD JOHN VANEK SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSCO
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3622
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241156A
MEDICARE PTAN
NC
05
—
6998778
—
NC
01
—
98778
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
09/11/2006
Last updated
07/28/2015
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