| Wyoming Cosmetic And Family Dental | |
|
4620 Grandview Ave Suite #101 Cheyenne WY 82009 | |
| (307) 635-2419 | |
| (307) 772-3443 |
| Full Name | Wyoming Cosmetic And Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 4620 Grandview Ave, Cheyenne, Wyoming |
| Authorized Official Name and Position | Jason Whiting (OWNER) |
| Authorized Official Contact | 3076352419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Cosmetic And Family Dental 4620 Grandview Ave Suite 101 Cheyenne WY 82009 Ph: (307) 635-2419 | Wyoming Cosmetic And Family Dental 4620 Grandview Ave Suite #101 Cheyenne WY 82009 Ph: (307) 635-2419 |
| NPI Number | 1194205401 |
|---|---|
| Provider Enumeration Date | 08/16/2018 |
| Last Update Date | 08/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194205401 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1199 (Wyoming) | Primary |
| 122300000X | Dentist | 1490 (Wyoming) | Secondary |
Wyoming Cosmetic And Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4620 Grandview Ave, Cheyenne, WY 82009 Phone: 307-635-2419 Fax: 307-772-3443 | |
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