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Individual

DR. STEPHANIE VANDYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
413 S 10TH ST, ATCHISON, KS 66002-2771
(913) 367-0203
(913) 367-5037
Mailing address
413 S 10TH ST, ATCHISON, KS 66002-2771
(913) 367-0203
(913) 367-5037

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6383
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100225290A
DORAL DENTAL
KS
01
16747019
BC/BS OF KC
MO
01
19358
BC/BS
KS
05
4054875701
KS
Enumeration date
08/10/2005
Last updated
08/19/2015
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