Organization
CHEYENNE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, L.L.C
Active
Organization
CHEYENNE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REX L. DOLAN D.D.S (OWNER)
(307) 635-6940
Entity
Organization
Contact information
Practice address
6238 YELLOWSTONE RD, CHEYENNE, WY 82009-3432
(307) 635-6940
(307) 635-2839
Mailing address
6238 YELLOWSTONE RD, CHEYENNE, WY 82009-3432
(307) 635-6940
(307) 635-2839
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121900600
—
WY
Enumeration date
07/24/2007
Last updated
07/18/2008
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