Organization
LARRY VANDYCK DDS HOLLY STREET DENTISTRY,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY EDWARD VANDYCK (OWNER/DENTIST)
(479) 524-0333
Entity
Organization
Contact information
Practice address
460 S HOLLY ST, SILOAM SPRINGS, AR 72761-3018
(479) 524-0333
(479) 524-0378
Mailing address
460 S HOLLY ST, PO BOX 460, SILOAM SPRINGS, AR 72761-3018
(479) 524-0333
(479) 524-0378
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3939
AR
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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