| NPI | 1962806331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY J GRIFFIN Office Manager 307-857-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WY 1220) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-10-14 |