Organization
TANNER FAMILY DENTISTRY, DEVIN K. TANNER DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEVIN K TANNER DDS (OWNER)
(208) 716-4382
Entity
Organization
Contact information
Practice address
220 SHOSHONE AVE, GREEN RIVER, WY 82935-5468
(307) 875-7770
Mailing address
PO BOX 127, GREEN RIVER, WY 82935-0127
(307) 875-7770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1382
WY
Other
Enumeration date
12/18/2014
Last updated
01/26/2015
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