# WYOMING ORAL & MAXILLOFACIAL SURGERY P. C.

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

## Provider details

- **NPI number:** 1356630057
- **Authorized official:** LUCAS A HARDY DMD (OWNER)
- **Authorized official phone:** (307) 235-1600

## Contact information

- **Practice address:** 4611 ARROYO DR SUITE 1, CASPER, WY 82604
- **Practice address phone:** (307) 235-1600
- **Practice address fax:** (307) 235-1601
- **Mailing address:** 4611 ARROYO DR SUITE 1, CASPER, WY 82604
- **Mailing address phone:** (307) 235-1600
- **Mailing address fax:** (307) 235-1601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 1146 | WY | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 1265 | WY | — |

## Other

- **Enumeration date:** 04/04/2011
- **Last updated:** 04/04/2011