Organization
CHILDREN'S DENTISTRY LLC
Active
Other names
The Smile Academy, Braces Wyoming
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLY CANTINE (INSURANCE COORDINATOR)
(307) 635-9251
Entity
Organization
Contact information
Practice address
6900 YELLOWTAIL RD STE 100, CHEYENNE, WY 82009-6102
(307) 635-9251
(307) 635-9218
Mailing address
6900 YELLOWTAIL RD, CHEYENNE, WY 82009-6102
(307) 635-9251
(307) 635-9218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
1040
WY
1223P0221X
Pediatric Dentistry
1108
WY
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
05/21/2007
Last updated
03/31/2024
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