Organization
MOUNTAIN DENTAL DUBOIS - AD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAYLOR ASHCRAFT (EXECUTIVE ADVISOR)
(208) 716-5669
Entity
Organization
Contact information
Practice address
104 N. 1ST STREET, DUBOIS, WY 82513
(307) 455-2229
Mailing address
PO BOX 777, DUBOIS, WY 82513-0777
(307) 455-2229
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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