Rufus O. Van Dyke, D.D.S., M.Cl.D

LBN: Rufus O. Van Dyke, D.D.S., M.Cl.D
Rufus O. Van Dyke, D.D.S., M.Cl.D is an health care organization with primary practice located at 1455 Bench Rd Suite A, Pocatello ID 83201-5083. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Rufus O. Van Dyke, D.D.S., M.Cl.D can be contacted via phone (208) 237-3330, or through Van Dyke, Tracy via phone (208) 237-3330.

Contact Information

Primary practice address
1455 Bench Rd Suite A Pocatello ID 83201-5083
Phone: (208) 237-3330
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Van Dyke, Tracy
Phone: (208) 237-3330

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X D-3206-OR Idaho

Profile Details

NPI number 1487802096
LBN Legal business name Rufus O. Van Dyke, D.D.S., M.Cl.D
DBA Doing business as
Authorized official Van Dyke, Tracy
Entity Organization
Organization subpart 1 No
Enumeration date Sep 8th, 2008
Last updated Sep 8th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487802096 NPPES
Idaho MEDICAID 9211318

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