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Organization
WHISKEY MOUNTAIN DENTAL
Active
Organization
WHISKEY MOUNTAIN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE DAY (OFFICE MANAGER DENTAL ASSISTANT)
(307) 455-2229
Entity
Organization
Contact information
Practice address
108 NORTH 1ST STREET, DUBOIS, WY 82513
(307) 455-2029
Mailing address
PO BOX 783, DUBOIS, WY 82513-0783
(307) 455-2229
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
08/28/2007
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