Organization
DENTAL ARTS PC
Active
Other names
Walgren Dental Arts PC
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY K WALGREN DDS (DENTIST/OWNER)
(307) 745-8513
Entity
Organization
Contact information
Practice address
3421 E GARFIELD ST, LARAMIE, WY 82070-5163
(307) 745-8513
(307) 745-0263
Mailing address
3421 E GARFIELD ST, LARAMIE, WY 82070-5163
(307) 745-8513
(307) 745-0263
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
921
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112311400
—
WY
Enumeration date
03/09/2017
Last updated
03/09/2017
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