Individual
TATE VANICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6101 VILLAGE DR STE 102, LINCOLN, NE 68516-5830
(402) 420-2600
Mailing address
924 S 39TH ST, LINCOLN, NE 68510-3524
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7161
NE
Other
Enumeration date
07/01/2014
Last updated
07/01/2014
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