Organization
HEART MOUNTAIN DENTAL L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA GEORGE D.D.S. (MANAGER)
(307) 587-6028
Entity
Organization
Contact information
Practice address
1426 STAMPEDE AVE, CODY, WY 82414-4226
(307) 587-6028
Mailing address
1426 STAMPEDE AVE, CODY, WY 82414-4226
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1419
WY
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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