Organization
ADVANCED DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUN ROGER ROCKNAK D.D.S. (OWNER)
(970) 685-1371
Entity
Organization
Contact information
Practice address
7112 COMMONS CIR, CHEYENNE, WY 82009-9999
(970) 685-1371
Mailing address
7112 COMMONS CIR, CHEYENNE, WY 82009-9999
(970) 685-1371
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1302
WY
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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