| NPI | 1821420720 |
|---|---|
| Doing Business As | 307 ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | KOLTON K ERICKSON President 307-237-8419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 1329) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2013-08-01 |