| NPI | 1942430640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT G BILLS Owner 307-332-9136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 740) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2009-07-16 |