| NPI | 1194084897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD E. COON General Dentist/President 307-672-7567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WY WY686) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WY WY1047) |
| 1223G0001X Dentist General Practice (Licence: WY WY1085) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |