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Organization
SOH OF WYOMING LLC
Active
Organization
SOH OF WYOMING LLC
Active
Parent organization
SOH OF WYOMING LLC
Other names
Westgate Dental Clinic, DBA Westgate Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOH OF WYOMING LLC
Authorized official
ASHLY KRISTINE SUNSHINE (CREDENTIALING SPECIALIST)
(314) 413-2803
Entity
Organization
Contact information
Practice address
121 W CARLSON ST, CHEYENNE, WY 82009-4044
(307) 635-1197
Mailing address
1190 MERAMEC STATION RD STE 110, BALLWIN, MO 63021-6902
(636) 362-4986
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
Primary
—
NULL
Other
Enumeration date
10/13/2021
Last updated
09/28/2026
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