| Oil City Dental Llc | |
|
1347 S Beverly St Casper WY 82609-4133 | |
| (307) 577-0577 | |
| (307) 234-4655 |
| Full Name | Oil City Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1347 S Beverly St, Casper, Wyoming |
| Authorized Official Name and Position | Kristie Jo Mooney (OFFICE MANAGER) |
| Authorized Official Contact | 3075770577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oil City Dental Llc 1347 S Beverly St Casper WY 82609-4133 Ph: (307) 577-0577 | Oil City Dental Llc 1347 S Beverly St Casper WY 82609-4133 Ph: (307) 577-0577 |
| NPI Number | 1629441290 |
|---|---|
| Provider Enumeration Date | 11/04/2015 |
| Last Update Date | 10/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629441290 | NPI | - | NPPES |
| 120733400 | Medicaid | WY | |
| 1023343852 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1233 (Wyoming) | Primary |
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