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Organization

DENISE R PRUGH DDS

Active
Other names
Surfin Smiles
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE ROBIN PRUGH DDS (OWNER)
(307) 265-7878
Entity
Organization

Contact information

Practice address
295 N WALSH DR, CASPER, WY 82609-1911
(307) 265-7878
(307) 268-4953
Mailing address
295 N WALSH DR, CASPER, WY 82609-1911
(307) 265-7878

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114491000
WY
Enumeration date
05/21/2015
Last updated
05/21/2015
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