| Casper Mountain Dental Dba Advanced Family Dental | |
|
1431 S. Beverly Street Casper WY 82609 | |
| (307) 265-5334 | |
| (307) 265-5336 |
| Full Name | Casper Mountain Dental Dba Advanced Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1431 S. Beverly Street, Casper, Wyoming |
| Authorized Official Name and Position | Aaron Larsen (OWNER) |
| Authorized Official Contact | 3072590058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Casper Mountain Dental Dba Advanced Family Dental 1431 S. Beverly Street Casper WY 82609 Ph: (307) 265-5334 | Casper Mountain Dental Dba Advanced Family Dental 1431 S. Beverly Street Casper WY 82609 Ph: (307) 265-5334 |
| NPI Number | 1164147666 |
|---|---|
| Provider Enumeration Date | 10/06/2022 |
| Last Update Date | 10/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164147666 | NPI | - | NPPES |
| 131751200 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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