Individual provider · Type 1 NPI

Rufus Van Dyke Iii, DDS, MCL.D

Orthodontics and Dentofacial Orthopedics Dentistry · Pocatello, ID

NPI number 1780604702 Active

Practice location

1501 Bench Rd
Pocatello, ID 83201-2443

Fax (208) 237-3347

Mailing address

1501 Bench Road
Pocatello, ID 83201-2443

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400XD-3206-OR (ID)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1780604702

Rufus Van Dyke Iii, DDS, MCL.D's National Provider Identifier is 1780604702, issued on Jul 20, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Pocatello, ID. The record was last updated on Jul 8, 2007.