Organization
BLUE TOOTH DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRY HANCOCK (OFFICE MANAGER)
(307) 789-9034
Entity
Organization
Contact information
Practice address
545 CHEYENNE DR, SUITE C, EVANSTON, WY 82930-5323
(307) 789-9034
(307) 789-9065
Mailing address
545 CHEYENNE DR, SUITE C, EVANSTON, WY 82930-5323
(307) 789-9034
(307) 789-9065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
715
WY
Other
Enumeration date
10/13/2008
Last updated
10/13/2008
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