| NPI | 1861909939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENELLE MARIE TOFT General Dentist 307-235-9198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WY 1318) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |