| NPI | 1649488743 |
|---|---|
| Doing Business As | THE SMILE ACADEMY |
| Doing Business As | BRACES WYOMING |
| Entity Type | Organization |
| Authorized Contact | MOLLY CANTINE Insurance Coordinator 307-635-9251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WY 1040) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WY 1108) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-03-31 |