Individual
DANTE F VACCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 323-8216
Mailing address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 323-8216
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
5826
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016113
—
NV
01
—
880167036A013
TRICARE
NV
01
—
CC0499
BC/BS
NV
05
—
XPY097980
—
CA
Enumeration date
05/23/2006
Last updated
03/25/2019
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