Individual
DR. CONNIE JOE HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 W CARLSON ST, CHEYENNE, WY 82009-4044
(307) 635-1197
(307) 635-3245
Mailing address
121 W CARLSON ST, CHEYENNE, WY 82009-4044
(307) 635-1197
(307) 635-3245
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
716
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
972193
UNITED CONCORDIA
WY
Enumeration date
03/15/2007
Last updated
07/08/2007
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