| NPI | 1508532482 |
|---|---|
| Former Legal Business Name | 2BREWERSANDACANUCKDENTAL LLC |
| Entity Type | Organization |
| Authorized Contact | JONATHAN MORGAN Owner 307-789-5210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2025-08-05 |