| Grand Avenue Dental Center | |
|
303 S 8th St Laramie WY 82070-3914 | |
| (307) 742-0722 | |
| (307) 742-0727 |
| Full Name | Grand Avenue Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 303 S 8th St, Laramie, Wyoming |
| Authorized Official Name and Position | Jennifer Rae Doser (PRESIDENT) |
| Authorized Official Contact | 3077420722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Avenue Dental Center 303 S 8th St Laramie WY 82070-3914 Ph: (307) 742-0722 | Grand Avenue Dental Center 303 S 8th St Laramie WY 82070-3914 Ph: (307) 742-0722 |
| NPI Number | 1073973780 |
|---|---|
| Provider Enumeration Date | 02/24/2016 |
| Last Update Date | 08/25/2016 |
| Medicare PECOS PAC ID | 9032401732 |
|---|---|
| Medicare Enrollment ID | O20160715000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073973780 | NPI | - | NPPES |
| 129817800 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1255 (Wyoming) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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Dr Thomas Mcgavey Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 S 8th St, Laramie, WY 82070 Phone: 307-745-5647 Fax: 307-721-9866 | |
Laramie Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3529 E Grand Ave, Laramie, WY 82070 Phone: 307-742-8484 Fax: 307-742-9426 | |
Summit View Dentistry, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3125 E Grand Ave Unit B, Laramie, WY 82070 Phone: 307-631-9262 | |
Laramie Family Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3529 E Grand Ave, Laramie, WY 82070 Phone: 307-742-8484 | |
Laramie Family Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3529 E Grand Ave, Laramie, WY 82070 Phone: 307-742-8484 |