| Cheyenne Periodontics, Pc | |
|
1401 Airport Pkwy Suite 110 Cheyenne WY 82001-1518 | |
| (307) 632-4574 | |
| (307) 632-4574 |
| Full Name | Cheyenne Periodontics, Pc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1401 Airport Pkwy, Cheyenne, Wyoming |
| Authorized Official Name and Position | John C. Van Ginkel (DENTIST) |
| Authorized Official Contact | 3076324574 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheyenne Periodontics, Pc 1401 Airport Pkwy Suite 110 Cheyenne WY 82001-1518 Ph: (307) 632-4574 | Cheyenne Periodontics, Pc 1401 Airport Pkwy Suite 110 Cheyenne WY 82001-1518 Ph: (307) 632-4574 |
| NPI Number | 1326127234 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 09/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326127234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 890 (Wyoming) | Primary |
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