Organization
JC DENTISTRY LLC
Active
Other names
Brookside Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED B CHRISTOPHERSON DDS (OWNER)
(307) 635-6300
Entity
Organization
Contact information
Practice address
229 STOREY BLVD STE A, CHEYENNE, WY 82009-3595
(307) 635-6300
(307) 635-6361
Mailing address
229 STOREY BLVD STE A, CHEYENNE, WY 82009-3595
(307) 635-6300
(307) 635-6361
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1416
WY
Other
Enumeration date
11/22/2016
Last updated
01/30/2017
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