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1538822374
ELKRIDGE DENTAL SOUTH LLC
JACKSON, WY
NPI
1538822374
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Entity Type
Organization
Authorized Contact
NATHAN TANNER
President
503-866-8454
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2021-10-19
Last Update Date
2021-10-19
Business Address
ELKRIDGE DENTAL SOUTH LLC
1315 S HWY 89
JACKSON, WY 83001-8514
Phone number: 307-733-4122
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Mailing Address
ELKRIDGE DENTAL SOUTH LLC
PO BOX 1190
JACKSON, WY 83001-1190
Phone number: 307-733-2555
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