Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
General Practice |
1223G0001X | |||
Orofacial Pain |
1223X2210X |
| NPI Number | 1689890899 |
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| Entity | Organization | ||||||||||||||||
| Organization subpart 1 | Not specified | ||||||||||||||||
| Enumeration date | 04/17/2007 | ||||||||||||||||
| Last updated | 05/19/2022 - About 4 years ago | ||||||||||||||||
| Identifiers |
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SCHUYLER A VANDYKE
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