Organization
DERRIK WALTON DDS & DARREN J. RUESCH DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRIK P WALTON DDS (PRESIDENT)
(307) 587-2951
Entity
Organization
Contact information
Practice address
1525 BLEISTEIN AVE, CODY, WY 82414-3806
(307) 587-2951
(307) 587-2760
Mailing address
1525 BLEISTEIN AVE, CODY, WY 82414-3806
(307) 587-2951
(307) 587-2760
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1008 & 1135
WY
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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