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Organization

JEFFRIES DENTAL, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. L. CARL JEFFRIES D.D.S. (DENTIST-CO-OWNER)
(307) 388-0137
Entity
Organization

Contact information

Practice address
3313 PAINTBRUSH LANE, WORLAND, WY 82401
(307) 347-3994
(307) 347-3697
Mailing address
3313 PAINTBRUSH LANE, WORLAND, WY 82401
(307) 347-3994
(307) 347-3697

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1005
WY
1223G0001X
General Practice Dentistry
1041
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113370500
WY
05
113827800
WY
05
113828600
WY
05
113829400
WY
Enumeration date
07/23/2007
Last updated
09/11/2020
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