| NPI | 1083191035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER CATHLIN OWENS Owner 307-733-3848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WY 128WY) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |