NPI 1194084897

Grinnell Street Dental Group

Organisation General Practice Dentistry Sheridan, WY

Practice location

Address: 108 E Grinnell St, Sheridan, WY 82801-3938
Phone: (307) 672-7567
Fax: (307) 673-0568

Authorised official

Name: Donald E. Coon
Title: General Dentist/President
Phone: (307) 672-7567

Registered specialties (3)

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence WY686 (WY)

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Registry record

NPI: 1194084897
Entity type: Organization
NPI issued: 15 May 2012
Record last updated: 15 May 2012

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.