| NPI | 1629441290 |
|---|---|
| Former Legal Business Name | TRU DENTAL LLC |
| Entity Type | Organization |
| Authorized Contact | KRISTIE JO MOONEY Office Manager 307-577-0577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1233) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2017-10-20 |