Organization
BEAR RIVER DENTAL
Active
Other names
Nathan R. Lester DMD PC
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN R LESTER DMD (OWNER)
(307) 789-5608
Entity
Organization
Contact information
Practice address
50 PARK RD, EVANSTON, WY 82930-2613
(307) 789-5608
(307) 789-4401
Mailing address
50 PARK RD, EVANSTON, WY 82930-2613
(307) 789-5608
(307) 789-4401
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1131
WY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1250
WY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1257
WY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
1202
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023268299
—
WY
05
—
1063492981
—
WY
05
—
1558432120
—
WY
05
—
1689795114
—
WY
Enumeration date
01/26/2011
Last updated
01/26/2011
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