| NPI | 1013330794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT QUIST Business Manager 307-672-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1310) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2014-01-30 |