Organization
DENTAL CARE OF FREMONT COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL EUGENE HAUCK DDS (DENTIST)
(307) 856-3463
Entity
Organization
Contact information
Practice address
1224 E JACKSON AVE, RIVERTON, WY 82501-3841
(307) 856-3463
(307) 856-9910
Mailing address
1224 E JACKSON AVE, RIVERTON, WY 82501-3841
(307) 856-3463
(307) 856-9910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1094
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118488100
—
WY
Enumeration date
02/12/2009
Last updated
02/12/2009
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