Individual
BRIAN J VINEYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
333 MAPLE STREET, SUTHERLAND, NE 69165
(308) 386-2236
(308) 386-3545
Mailing address
910 WEST PHILLIP, NORTH PLATTE, NE 69101
(308) 532-8623
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4783
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05658
BLUE CROSS
NE
05
—
47066065614
—
NE
Enumeration date
07/28/2006
Last updated
07/08/2007
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