Organization
ROBERT P. TYRRELL, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL WOOD (OFFICE MANAGER)
(307) 877-4715
Entity
Organization
Contact information
Practice address
1702 ANTELOPE STREET, KEMMERER, WY 83101-3900
(307) 877-4715
(307) 877-3475
Mailing address
PO BOX 228, KEMMERER, WY 83101-0228
(307) 877-4715
(307) 877-3475
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
813
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116184900
—
WY
Enumeration date
06/17/2015
Last updated
06/17/2015
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