| Roy E. Paulson Jr Pc | |
|
2805 Cedar Ave Ste A Gillette WY 82718-2000 | |
| (307) 686-7635 | |
| (307) 237-4424 |
| Full Name | Roy E. Paulson Jr Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2805 Cedar Ave Ste A, Gillette, Wyoming |
| Authorized Official Name and Position | Roy Edward Paulson (PEDIATRIC DENTIST) |
| Authorized Official Contact | 3076867635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roy E. Paulson Jr Pc 2805 Cedar Ave Ste A Gillette WY 82718-2000 Ph: (307) 686-7635 | Roy E. Paulson Jr Pc 2805 Cedar Ave Ste A Gillette WY 82718-2000 Ph: (307) 686-7635 |
| NPI Number | 1821207036 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 03/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821207036 | NPI | - | NPPES |
| 112331901 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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