| NPI | 1225184575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN NEIL GINEST President, Owner 307-754-5502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 692) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |