DR. Jack L Vandyke, DMD

NPI #1417161555 in Woodland, Washington

Provider Information

NPI Number: 1417161555
Entity Type: Individual
Name: DR. Jack L Vandyke, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: May 9, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 640 GEORIG ST
City: Woodland
State: Washington
ZIP Code: 98674
Phone: (360) 225-9494

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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