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Organization
WYOMING COSMETIC AND FAMILY DENTAL
Active
Organization
WYOMING COSMETIC AND FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON N WHITING DMD (DENTIST)
(307) 635-2419
Entity
Organization
Contact information
Practice address
4620 GRANDVIEW AVE, CHEYENNE, WY 82009-4963
(307) 635-2419
(307) 772-3443
Mailing address
4620 GRANDVIEW AVE, CHEYENNE, WY 82009-4963
(307) 635-2419
(307) 772-3443
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1199
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265421077
INDIVIDUAL NPI
WY
Enumeration date
10/24/2008
Last updated
10/24/2008
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