# OIL CITY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TRU Dental LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629441290
- **Authorized official:** KRISTIE JO MOONEY (OFFICE MANAGER)
- **Authorized official phone:** (307) 577-0577

## Contact information

- **Practice address:** 1347 S BEVERLY ST, CASPER, WY 82609-4133
- **Practice address phone:** (307) 577-0577
- **Practice address fax:** (307) 234-4655
- **Mailing address:** 1347 S BEVERLY ST, CASPER, WY 82609-4133
- **Mailing address phone:** (307) 577-0577
- **Mailing address fax:** (307) 234-4655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1233 | WY | Yes |

## Other

- **Enumeration date:** 11/04/2015
- **Last updated:** 10/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1023343852 | — | WY |
| 05 | — | 120733400 | — | WY |