# JEFFRIES DENTAL, P.C.

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

## Provider details

- **NPI number:** 1316147952
- **Authorized official:** DR. L. CARL JEFFRIES D.D.S. (DENTIST-CO-OWNER)
- **Authorized official phone:** (307) 388-0137

## Contact information

- **Practice address:** 3313 PAINTBRUSH LANE, WORLAND, WY 82401
- **Practice address phone:** (307) 347-3994
- **Practice address fax:** (307) 347-3697
- **Mailing address:** 3313 PAINTBRUSH LANE, WORLAND, WY 82401
- **Mailing address phone:** (307) 347-3994
- **Mailing address fax:** (307) 347-3697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1005 | WY | Yes |
| 1223G0001X | General Practice Dentistry | 1041 | WY | — |

## Other

- **Enumeration date:** 07/23/2007
- **Last updated:** 09/11/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 113370500 | — | WY |
| 05 | — | 113827800 | — | WY |
| 05 | — | 113828600 | — | WY |
| 05 | — | 113829400 | — | WY |