Organization Name: | SUNSET DENTAL CARE PC |
NPI Number: | 1962511154 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCHUYLER ANNE VANDYKE (DENTIST DMD) |
Mailing Address: | 417 2nd Ave Sw Conrad |
State: | MT US |
Postal Code: | 59425 |
Phone Number: | 4062783609 |
Fax Number: | 4062785458 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 10/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |