Individual
DR. CHARLES DOUGLAS VANDYCK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
2601 16TH AVE S, GREAT FALLS, MT 59405-5202
(406) 727-6232
Mailing address
2601 16TH AVE S, GREAT FALLS, MT 59405-5202
(406) 727-6232
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
1369
MT
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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