Organization
JACKSON FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARY G. SMITH D.M.D (GENERAL PARTNER)
(307) 733-7044
Entity
Organization
Contact information
Practice address
1115 MAPLEWAY, JACKSON, WY 83001
(307) 733-7044
(307) 734-1409
Mailing address
PO BOX 9248, JACKSON, WY 83002-9248
(307) 733-7044
(307) 734-1409
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
756
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112319000
—
WY
Enumeration date
03/16/2007
Last updated
03/28/2016
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