Organization
SHERIDAN WYO DENTAL
Active
Other names
Hal Quist, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAT QUIST (OFFICE MANAGER)
(307) 672-2328
Entity
Organization
Contact information
Practice address
2 N MAIN ST, STE 405, SHERIDAN, WY 82801-6318
(307) 672-7439
Mailing address
2 N MAIN ST, STE 405, SHERIDAN, WY 82801-6318
(307) 672-7439
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106690100
—
WY
Enumeration date
03/11/2013
Last updated
03/11/2013
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