Organization
DR. MARK VANICEK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK VANICEK (DDS)
(402) 420-2600
Entity
Organization
Contact information
Practice address
6101 VILLAGE DR STE 102, LINCOLN, NE 68516-5830
(402) 420-2600
Mailing address
7621 KENNELLEY DR, LINCOLN, NE 68516-3797
(402) 420-2600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5311
NE
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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