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Organization
MOSS DENTISTRY
Active
Organization
MOSS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLEY J GRIFFIN (OFFICE MANAGER)
(307) 857-2020
Entity
Organization
Contact information
Practice address
203 E MAIN STREET, SUITE 205, RIVERTON, WY 82501
(307) 857-2020
(307) 857-2727
Mailing address
203 E MAIN STREET, SUITE 205, RIVERTON, WY 82501
(307) 857-2020
(307) 857-2727
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1220
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127527500
—
WY
Enumeration date
10/14/2014
Last updated
10/14/2014
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