Organization
GILLETTE PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GLENN BAILEY D.D.S. (PEDIATRIC DENTIST)
(307) 670-8118
Entity
Organization
Contact information
Practice address
433 SHADOW RIDGE BLVD, SHERIDAN, WY 82801-9350
(307) 670-8118
Mailing address
530 RUNNING W DRIVE, SUITE 100, GILLETTE, WY 82718-2003
(307) 670-8118
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1271
WY
Other
Enumeration date
02/07/2012
Last updated
01/06/2017
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