Organization
OIL CITY DENTAL LLC
Active
Other names
TRU Dental LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIE JO MOONEY (OFFICE MANAGER)
(307) 577-0577
Entity
Organization
Contact information
Practice address
1347 S BEVERLY ST, CASPER, WY 82609-4133
(307) 577-0577
(307) 234-4655
Mailing address
1347 S BEVERLY ST, CASPER, WY 82609-4133
(307) 577-0577
(307) 234-4655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1233
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023343852
—
WY
05
—
120733400
—
WY
Enumeration date
11/04/2015
Last updated
10/20/2017
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