Organization
JENNIFER DOSER DMD PC
Active
Other names
Grand Avenue Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RAE DOSER DMD (PRESIDENT)
(307) 742-0722
Entity
Organization
Contact information
Practice address
303 S 8TH ST, LARAMIE, WY 82070-3914
(307) 742-0722
(307) 742-0727
Mailing address
303 S 8TH ST, LARAMIE, WY 82070-3914
(307) 742-0722
(307) 742-0727
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1255
WY
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129817800
—
WY
Enumeration date
02/24/2016
Last updated
08/25/2016
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