| NPI | 1013289966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GLENN BAILEY Pediatric Dentist 307-670-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WY 1271) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2017-01-06 |