# DERRIK WALTON DDS & DARREN J. RUESCH DDS, PC

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

## Provider details

- **NPI number:** 1154523728
- **Authorized official:** DR. DERRIK P WALTON DDS (PRESIDENT)
- **Authorized official phone:** (307) 587-2951

## Contact information

- **Practice address:** 1525 BLEISTEIN AVE, CODY, WY 82414-3806
- **Practice address phone:** (307) 587-2951
- **Practice address fax:** (307) 587-2760
- **Mailing address:** 1525 BLEISTEIN AVE, CODY, WY 82414-3806
- **Mailing address phone:** (307) 587-2951
- **Mailing address fax:** (307) 587-2760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1008 & 1135 | WY | Yes |

## Other

- **Enumeration date:** 06/04/2007
- **Last updated:** 08/22/2020