# ROBERT P. TYRRELL, D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104207927
- **Authorized official:** RACHEL WOOD (OFFICE MANAGER)
- **Authorized official phone:** (307) 877-4715

## Contact information

- **Practice address:** 1702 ANTELOPE STREET, KEMMERER, WY 83101-3900
- **Practice address phone:** (307) 877-4715
- **Practice address fax:** (307) 877-3475
- **Mailing address:** PO BOX 228, KEMMERER, WY 83101-0228
- **Mailing address phone:** (307) 877-4715
- **Mailing address fax:** (307) 877-3475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 813 | WY | Yes |

## Other

- **Enumeration date:** 06/17/2015
- **Last updated:** 06/17/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 116184900 | — | WY |