Organization
PAINTBRUSH DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEIF A POLSON (OWNER)
(307) 864-9411
Entity
Organization
Contact information
Practice address
110 E ARAPAHOE ST, THERMOPOLIS, WY 82443
(307) 864-9411
(307) 864-2756
Mailing address
110 E ARAPAHOE ST, PO BOX 751, THERMOPOLIS, WY 82440-0751
(307) 864-9411
(307) 864-2756
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1222
WY
Other
Enumeration date
11/25/2009
Last updated
11/25/2009
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