| Pediatric Dentistry, P.c. | |
|
1439 Stillwater Ave Ste 7 Cheyenne WY 82009-7367 | |
| (307) 778-7100 | |
| (307) 778-2824 |
| Full Name | Pediatric Dentistry, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1439 Stillwater Ave Ste 7, Cheyenne, Wyoming |
| Authorized Official Name and Position | John R Leonard (OWNER) |
| Authorized Official Contact | 3077787100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry, P.c. 1439 Stillwater Ave Ste 7 Cheyenne WY 82009-7367 Ph: (307) 778-7100 | Pediatric Dentistry, P.c. 1439 Stillwater Ave Ste 7 Cheyenne WY 82009-7367 Ph: (307) 778-7100 |
| NPI Number | 1326118993 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326118993 | NPI | - | NPPES |
| 974672 | Other | WY | UNITED CONCORDIA CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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