| NPI | 1780745190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PARLEY JACK FELLER Owner 307-362-8842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WY 743) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WY 1158) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2014-03-13 |