| NPI | 1386884054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY L KNAUB Practice Owner 307-745-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1200) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WY 777) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2017-12-05 |