| Sugarland Dental Pc | |
|
941a Sugarland Drive Sheridan WY 82801 | |
| (307) 673-5522 | |
| (307) 673-0658 |
| Full Name | Sugarland Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 941a Sugarland Drive, Sheridan, Wyoming |
| Authorized Official Name and Position | Brian Jeffrey Cook (PRESIDENT SUGARLAND DENTAL PC) |
| Authorized Official Contact | 3076735522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sugarland Dental Pc 941a Sugarland Drive Sheridan WY 82801 Ph: (307) 673-5522 | Sugarland Dental Pc 941a Sugarland Drive Sheridan WY 82801 Ph: (307) 673-5522 |
| NPI Number | 1922110147 |
|---|---|
| Provider Enumeration Date | 09/01/2006 |
| Last Update Date | 04/26/2016 |
| Medicare PECOS PAC ID | 1951729383 |
|---|---|
| Medicare Enrollment ID | O20200916001133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922110147 | NPI | - | NPPES |
| 120907800 | Medicaid | WY |
| Provider Name | Brian J Cook |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1942538384 PECOS PAC ID: 5496893547 Enrollment ID: I20201019000354 |
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