NPI 1003069865

Wyoming Cosmetic and Family Dental

Organisation Dental Clinic/Center Cheyenne, WY

Practice location

Address: 4620 Grandview Ave, Cheyenne, WY 82009-4963
Phone: (307) 635-2419
Fax: (307) 772-3443

Authorised official

Name: Jason N Whiting
Title: Dentist
Phone: (307) 635-2419

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence 1199 (WY)

Other Clinic/Center providers in Wyoming →

Registry record

NPI: 1003069865
Entity type: Organization
NPI issued: 24 Oct 2008
Record last updated: 24 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.