| NPI | 1073885224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RATTS Owner 307-746-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 724) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WY 1264) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-09 |