| NPI | 1689117608 |
|---|---|
| Doing Business As | BROOKSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JARED B CHRISTOPHERSON Owner 307-635-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1416) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2017-01-30 |