NPI 1194205401

Wyoming Cosmetic and Family Dental

Organisation Dentist Cheyenne, WY

Practice location

Address: 4620 Grandview Ave Suite #101, Cheyenne, WY 82009
Phone: (307) 635-2419
Fax: (307) 772-3443
Mailing address: 4620 Grandview Ave Suite 101, Cheyenne, WY 82009

Authorised official

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

Registered specialties (2)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 1199 (WY)

Other Dentist providers in Wyoming →

Dentist

Dental Providers Taxonomy 122300000X Licence 1490 (WY)

Registry record

NPI: 1194205401
Entity type: Organization
NPI issued: 16 Aug 2018
Record last updated: 16 Aug 2018

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.