| 307 Orthodontics | |
|
932 S David St Casper WY 82601-3738 | |
| (307) 237-8419 | |
| (307) 234-4912 |
| Full Name | 307 Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 932 S David St, Casper, Wyoming |
| Authorized Official Name and Position | Kolton K Erickson (PRESIDENT) |
| Authorized Official Contact | 3072378419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 307 Orthodontics Po Box 2190 Casper WY 82602-2190 Ph: (307) 237-8419 | 307 Orthodontics 932 S David St Casper WY 82601-3738 Ph: (307) 237-8419 |
| NPI Number | 1821420720 |
|---|---|
| Provider Enumeration Date | 08/01/2013 |
| Last Update Date | 08/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821420720 | NPI | - | NPPES |
| 1770893414 | Other | WY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 1329 (Wyoming) | Primary |
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