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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