Rufus O. Van Dyke, D.d.s., M.cl.d

NPI #1487802096 in Pocatello, Idaho

Provider Information

NPI Number: 1487802096
Entity Type: Organization
Organization Name: Rufus O. Van Dyke, D.d.s., M.cl.d
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Sep 8, 2008
Last Updated: Sep 8, 2008

Practice Location

Address: 1455 BENCH RD
Address 2: SUITE A
City: Pocatello
State: Idaho
ZIP Code: 83201-5083
Phone: (208) 237-3330

Authorized Official

Name: TRACY VAN DYKE
Title: OFFICE MANAGER
Phone: (208) 237-3330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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