Individual
HAROLD MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1224 E JACKSON AVE, RIVERTON, WY 82501-3841
(307) 856-3463
(307) 856-9910
Mailing address
1224 E JACKSON AVE, RIVERTON, WY 82501-3841
(307) 856-3463
(307) 856-9910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
464
WY
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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