Provider Demographics
NPI:1982632121
Name:MCVANEY, TIMOTHY PATRICK (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:MCVANEY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:12242 K PLZ
Mailing Address - Street 2:SUITE 113
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2260
Mailing Address - Country:US
Mailing Address - Phone:402-334-8083
Mailing Address - Fax:402-334-0834
Practice Address - Street 1:12165 W CENTER ROAD
Practice Address - Street 2:SUITE 76
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3962
Practice Address - Country:US
Practice Address - Phone:402-334-8083
Practice Address - Fax:402-334-0834
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NENE43321223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics