Individual
DR. GAIGE RYAN VANDEZANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
804 S 3RD ST, ST CHARLES, IL 60174-4053
(630) 377-1200
(630) 377-9801
Mailing address
2142 PRENTISS DR APT 112, DOWNERS GROVE, IL 60516-2214
(704) 245-2170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019033650
IL
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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