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Pediatric Dentistry

Rock Springs, Wyoming

Provider NPI: 1336458397

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 307-362-3395  Fax: --

Business Mailing Address:
Tel: 307-362-3395  Fax: --

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N1223P0221XDental Providers
Pediatric Dentistry
Y1223P0221XDental Providers


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