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Organization
CASPER MOUNTAIN DENTAL DBA ADVANCED FAMILY DENTAL
Active
Organization
CASPER MOUNTAIN DENTAL DBA ADVANCED FAMILY DENTAL
Active
Parent organization
CASPER MOUNTAIN DENTAL
Other names
Casper Mountain Dental dba Glenrock Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
CASPER MOUNTAIN DENTAL
Authorized official
AARON LARSEN DDS (OWNER)
(307) 259-0058
Entity
Organization
Contact information
Practice address
1431 S. BEVERLY STREET, CASPER, WY 82609
(307) 265-5334
(307) 265-5336
Mailing address
1431 S. BEVERLY STREET, CASPER, WY 82609
(307) 265-5334
(307) 265-5336
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131751200
—
WY
Enumeration date
10/06/2022
Last updated
10/06/2022
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