| Dr Riley Pc | |
|
1325 S Hwy 89 Apt 105 Jackson WY 83001-8293 | |
| (307) 201-5668 | |
| Not Available |
| Full Name | Dr Riley Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1325 S Hwy 89 Apt 105, Jackson, Wyoming |
| Authorized Official Name and Position | Riley Jared Hicks (DENTAL SPECIALIST/ OWNER) |
| Authorized Official Contact | 3072015668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Riley Pc Po Box 11606 Jackson WY 83002-1606 Ph: () - | Dr Riley Pc 1325 S Hwy 89 Apt 105 Jackson WY 83001-8293 Ph: (307) 201-5668 |
| NPI Number | 1639792450 |
|---|---|
| Provider Enumeration Date | 05/27/2020 |
| Last Update Date | 05/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639792450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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