# RIVERTON DENTAL CENTER PC

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

## Provider details

- **NPI number:** 1205963600
- **Authorized official:** GUY SALISBURY MENEFEE DDS (OWNER DENTIST)
- **Authorized official phone:** (307) 857-5200

## Contact information

- **Practice address:** 325 W MAIN, \#G, RIVERTON, WY 82501
- **Practice address phone:** (307) 856-8660
- **Mailing address:** 325 W MAIN, \#G, RIVERTON, WY 82501
- **Mailing address phone:** (307) 856-8660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 981 | WY | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 303959 | BCBS | WY |