| Cheyenne Facial Imaging Center | |
|
1401 Airport Pkwy Ste 210 Cheyenne WY 82001-1541 | |
| (307) 316-4101 | |
| (307) 224-1089 |
| Full Name | Cheyenne Facial Imaging Center |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1401 Airport Pkwy Ste 210, Cheyenne, Wyoming |
| Authorized Official Name and Position | Jason L. Bird (ORTHODONTIST) |
| Authorized Official Contact | 3073164101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheyenne Facial Imaging Center 1401 Airport Pkwy Ste 210 Cheyenne WY 82001-1541 Ph: (307) 316-4101 | Cheyenne Facial Imaging Center 1401 Airport Pkwy Ste 210 Cheyenne WY 82001-1541 Ph: (307) 316-4101 |
| NPI Number | 1427421676 |
|---|---|
| Provider Enumeration Date | 11/10/2015 |
| Last Update Date | 11/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427421676 | NPI | - | NPPES |
| 121770400 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 999 (Wyoming) | Primary |
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