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Organization
OIL CITY DENTAL LLC
Active
Organization
OIL CITY DENTAL LLC
Active
Other names
TRU Dental LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIE JO MOONEY (OFFICE MANAGER)
(307) 577-0577
Entity
Organization
Contact information
Practice address
1347 S BEVERLY ST, CASPER, WY 82609-4133
(307) 577-0577
(307) 234-4655
Mailing address
1347 S BEVERLY ST, CASPER, WY 82609-4133
(307) 577-0577
(307) 234-4655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1233
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023343852
—
WY
05
—
120733400
—
WY
Enumeration date
11/04/2015
Last updated
10/20/2017
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