| NPI | 1316147952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L. CARL JEFFRIES Dentist Co Owner 307-388-0137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1005) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WY 1041) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2020-09-11 |