Individual
DR. SCOTTY N VANDUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2795 SKYLINE CT, GRAND JUNCTION, CO 81506-3908
(970) 242-3545
(970) 254-9849
Mailing address
2795 SKYLINE CT, GRAND JUNCTION, CO 81506-3908
(970) 242-3545
(970) 254-9849
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
100986
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43604561
—
CO
Enumeration date
11/29/2006
Last updated
07/08/2007
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