Larame Dental Arts Pc | |
352 N 4th St Laramie WY 82072-3106 | |
(307) 745-5020 | |
(307) 745-0856 |
Full Name | Larame Dental Arts Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 352 N 4th St, Laramie, Wyoming |
Authorized Official Name and Position | Troy L Knaub (PRACTICE OWNER) |
Authorized Official Contact | 3077455020 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Larame Dental Arts Pc 352 N 4th St Laramie WY 82072-3106 Ph: (307) 745-5020 | Larame Dental Arts Pc 352 N 4th St Laramie WY 82072-3106 Ph: (307) 745-5020 |
NPI Number | 1386884054 |
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Provider Enumeration Date | 02/20/2009 |
Last Update Date | 12/05/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386884054 | NPI | - | NPPES |
106285900 | Medicaid | WY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 1200 (Wyoming) | Primary |
1223G0001X | Dentist - General Practice | 777 (Wyoming) | Secondary |
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