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Oral and Maxillofacial Surgery

Casper, Wyoming

Provider NPI: 1356630057

Organization Information:
Organization is not Subpart
Authorized Official:  LUCAS A HARDY  OWNER  307-2351600

Practice Location:
Tel: 307-235-1600  Fax: 307-235-1601

Business Mailing Address:
Tel: 307-235-1600  Fax: 307-235-1601

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N1223S0112XDental Providers
Oral and Maxillofacial Surgery
Y1223S0112XDental Providers


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