Organization
BOZEMAN TRAIL ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES LEWIS WETZEL JR. DDS (PRESIDENT)
(307) 237-8419
Entity
Organization
Contact information
Practice address
932 SOUTH DAVID ST, CASPER, WY 82601
(307) 237-8419
(307) 234-4912
Mailing address
932 SOUTH DAVID ST, CASPER, WY 82601
(307) 237-8419
(307) 234-4912
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
546
WY
Other
Enumeration date
08/29/2006
Last updated
08/22/2020
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