Individual
KYLIE GRANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
352 N 4TH ST, LARAMIE, WY 82072-3106
(307) 745-5020
Mailing address
MSC 09 5020 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-4031
(505) 272-5584
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1605
WY
390200000X
Student in an Organized Health Care Education/Training Program
TD-00-146
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
05/13/2021
Last updated
11/29/2022
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