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Organization

SOH OF WYOMING LLC

Active
Parent organization
SOH OF WYOMING LLC
Other names
DBA Westgate Dental
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOH OF WYOMING LLC
Authorized official
ASHLY KRISTINE SUNSHINE (CREDENTIALING SPECIALIST)
(314) 413-2803
Entity
Organization

Contact information

Practice address
121 W CARLSON ST, CHEYENNE, WY 82009-4044
(307) 635-1197
Mailing address
121 W CARLSON ST, CHEYENNE, WY 82009-4044
(307) 635-1197

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
10/13/2021
Last updated
06/01/2023
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