Individual
DR. BRADLEY K WALGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3421 E GARFIELD, LARAMIE, WY 82070
(307) 745-8513
(307) 745-0263
Mailing address
3421 E GARFIELD, LARAMIE, WY 82070
(307) 745-8513
(307) 745-0263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
921
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112311400
—
WY
Enumeration date
07/11/2006
Last updated
02/16/2017
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