Organization
WYOMING COSMETIC AND FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON WHITING DMD (OWNER)
(307) 635-2419
Entity
Organization
Contact information
Practice address
4620 GRANDVIEW AVE, SUITE #101, CHEYENNE, WY 82009
(307) 635-2419
(307) 772-3443
Mailing address
4620 GRANDVIEW AVE, SUITE 101, CHEYENNE, WY 82009
(307) 635-2419
(307) 772-3443
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1199
WY
122300000X
Dentist
1490
WY
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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