| NPI | 1285841148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS RICHARD BRENKERT Member 307-638-8958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 962) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |