Organization
ROY E. PAULSON JR PC
Active
Other names
Casper Children's Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY EDWARD PAULSON DDS (PEDIATRIC DENTIST)
(307) 266-1997
Entity
Organization
Contact information
Practice address
102 N. KENWOOD ST., CASPER, WY 82601-2724
(307) 266-1997
(307) 237-4424
Mailing address
102 N. KENWOOD ST., CASPER, WY 82601-2724
(307) 266-1997
(307) 237-4424
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112331900
—
WY
01
—
A0H1301FUMCMEAT
CMS EHR CERTIFICATION
—
Enumeration date
06/06/2007
Last updated
03/17/2015
Update your record
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