Organization
GILLETTE ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WARD DDS, MSD (OWNER)
(208) 918-5622
Entity
Organization
Contact information
Practice address
530 RUNNING W DR, SUITE 100, GILLETTE, WY 82718-2074
(307) 257-2550
Mailing address
530 RUNNING W DR, SUITE 100, GILLETTE, WY 82718-2074
(307) 257-2550
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1353
WY
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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