| NPI | 1922420009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALLISTA MARIE HOLWEGNER Orthodontist 307-638-8958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 1285) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |