| Wyoming Cosmetic And Family Dental | |
|
4620 Grandview Ave Cheyenne WY 82009-4963 | |
| (307) 635-2419 | |
| (307) 772-3443 |
| Full Name | Wyoming Cosmetic And Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4620 Grandview Ave, Cheyenne, Wyoming |
| Authorized Official Name and Position | Jason N Whiting (DENTIST) |
| Authorized Official Contact | 3076352419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Cosmetic And Family Dental 4620 Grandview Ave Cheyenne WY 82009-4963 Ph: (307) 635-2419 | Wyoming Cosmetic And Family Dental 4620 Grandview Ave Cheyenne WY 82009-4963 Ph: (307) 635-2419 |
| NPI Number | 1003069865 |
|---|---|
| Provider Enumeration Date | 10/24/2008 |
| Last Update Date | 10/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003069865 | NPI | - | NPPES |
| 1265421077 | Other | WY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1199 (Wyoming) | Primary |
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