| NPI | 1497988356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER BARNEY CARLSON Owner/Dentist 307-362-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WY 1216) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2015-03-09 |