| Robert P. Tyrrell, D.d.s. | |
|
1702 Antelope Street Kemmerer WY 83101-3900 | |
| (307) 877-4715 | |
| (307) 877-3475 |
| Full Name | Robert P. Tyrrell, D.d.s. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1702 Antelope Street, Kemmerer, Wyoming |
| Authorized Official Name and Position | Rachel Wood (OFFICE MANAGER) |
| Authorized Official Contact | 3078774715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert P. Tyrrell, D.d.s. Po Box 228 Kemmerer WY 83101-0228 Ph: (307) 877-4715 | Robert P. Tyrrell, D.d.s. 1702 Antelope Street Kemmerer WY 83101-3900 Ph: (307) 877-4715 |
| NPI Number | 1104207927 |
|---|---|
| Provider Enumeration Date | 06/17/2015 |
| Last Update Date | 06/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104207927 | NPI | - | NPPES |
| 116184900 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 813 (Wyoming) | Primary |
Diamond G Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1702 Antelope Street, Kemmerer, WY 83101 Phone: 307-877-4715 |