Healthcare Provider Details

I. General information

NPI: 1689890899
Provider Name (Legal Business Name): SCHUYLER ANNE VANDYKE D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 SOLLID RD
CONRAD MT
59425-9222
US

IV. Provider business mailing address

1929 SOLLID RD
CONRAD MT
59425-9222
US

V. Phone/Fax

Practice location:
  • Phone: 406-952-0154
  • Fax: 406-952-0153
Mailing address:
  • Phone: 406-952-0154
  • Fax: 406-952-0153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number1880
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1880
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number1880
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: