| NPI | 1427421676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON L. BIRD Orthodontist 307-316-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 999) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |