| Laramie Family Dental, Pc | |
|
3529 E Grand Ave Laramie WY 82070-5135 | |
| (307) 742-8484 | |
| Not Available |
| Full Name | Laramie Family Dental, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3529 E Grand Ave, Laramie, Wyoming |
| Authorized Official Name and Position | David Maki (DENTIST) |
| Authorized Official Contact | 3077428484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laramie Family Dental, Pc 3529 E Grand Ave Laramie WY 82070-5135 Ph: (307) 742-8484 | Laramie Family Dental, Pc 3529 E Grand Ave Laramie WY 82070-5135 Ph: (307) 742-8484 |
| NPI Number | 1538488317 |
|---|---|
| Provider Enumeration Date | 05/19/2010 |
| Last Update Date | 12/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538488317 | NPI | - | NPPES |
| 93239564 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 9642 (Colorado) | Secondary |
| 261QD0000X | Clinic/center - Dental | 1243 (Wyoming) | Primary |
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