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1023863768
EVANSTON DENTAL,LLC
EVANSTON, WY
NPI
1023863768
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Entity Type
Organization
Authorized Contact
MICAH DANIEL HIMMERICH
Owner/Member
307-789-0500
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2024-04-17
Last Update Date
2024-04-17
Business Address
EVANSTON DENTAL,LLC
1425 HIGHWAY 150 S
EVANSTON, WY 82930-5377
Phone number: 307-789-0500
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Mailing Address
EVANSTON DENTAL,LLC
1425 HIGHWAY 150 S
EVANSTON, WY 82930-5377
Phone number: 307-789-0500
Copy
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