Individual
DR. MICAH DANIEL HIMMERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
100 CANYON ROAD, DIAMONDVILLE, WY 83116
(307) 877-6951
Mailing address
100 CANYON ROAD, PO BOX 314, DIAMONDVILLE, WY 83116
(307) 877-6951
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1247
WY
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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