Organization
PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW C HENRY D.D.S. (OWNER)
(307) 778-7100
Entity
Organization
Contact information
Practice address
1439 STILLWATER AVE STE 7, CHEYENNE, WY 82009-7367
(307) 778-7100
(307) 778-2824
Mailing address
1439 STILLWATER AVE STE 7, CHEYENNE, WY 82009-7367
(307) 778-7100
(307) 778-2824
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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