Organization
DAVIS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL THOMASSON DAVIS D.D.S. (DENTIST)
(307) 634-3488
Entity
Organization
Contact information
Practice address
3116 ACACIA DR, CHEYENNE, WY 82001-5804
(307) 634-3488
Mailing address
3116 ACACIA DR, CHEYENNE, WY 82001-5804
(307) 634-3488
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1275
WY
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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