| NPI | 1568671717 |
|---|---|
| Doing Business As | BROOKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | GERALD LYNN ROWE President Owner 307-635-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |