Organization
EAGLE SUMMIT DENTAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA BURRIDGE (OFFICE MANAGER)
(307) 684-0119
Entity
Organization
Contact information
Practice address
1001 EAGLE VIEW DR, BUFFALO, WY 82834-1422
(307) 684-0119
(307) 684-0120
Mailing address
1001 EAGLE VIEW DR, BUFFALO, WY 82834-1422
(307) 684-0119
(307) 684-0120
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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