Provider Demographics
NPI:1639854284
Name:VB DENTISTRY LLC
Entity Type:Organization
Organization Name:VB DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKTORYIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:507-398-1377
Mailing Address - Street 1:12405 DEER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-1684
Mailing Address - Country:US
Mailing Address - Phone:507-398-1377
Mailing Address - Fax:
Practice Address - Street 1:258 N 114TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2515
Practice Address - Country:US
Practice Address - Phone:402-334-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental