Organization
DESIGNER SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD MICHAEL CLARK DDS (PRESIDENT)
(307) 240-9966
Entity
Organization
Contact information
Practice address
405 E 19TH ST, CHEYENNE, WY 82001-4643
(307) 343-5676
Mailing address
604 MEADOWLARK LN, RIVERTON, WY 82501-2214
(307) 343-5676
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
12/01/2023
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