| Kincheloe Dental Office, Pc | |
|
6244 Yellowstone Rd Cheyenne WY 82009-3432 | |
| (307) 638-8520 | |
| Not Available |
| Full Name | Kincheloe Dental Office, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6244 Yellowstone Rd, Cheyenne, Wyoming |
| Authorized Official Name and Position | Bradley B Kincheloe (OFFICER) |
| Authorized Official Contact | 3076388520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kincheloe Dental Office, Pc 2625 Wildhorse Trl Cheyenne WY 82009-2232 Ph: (307) 638-6544 | Kincheloe Dental Office, Pc 6244 Yellowstone Rd Cheyenne WY 82009-3432 Ph: (307) 638-8520 |
| NPI Number | 1881711174 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881711174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1070 (Wyoming) | Primary |
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