| NPI | 1255725297 |
|---|---|
| Doing Business As | WESTGATE DENTAL |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN J HARRELL Dentist 307-635-1197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WY 1173) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: WY 1355) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |