Grinnell Street Dental Group

NPI #1194084897 in Sheridan, Wyoming

Provider Information

NPI Number: 1194084897
Entity Type: Organization
Organization Name: Grinnell Street Dental Group
Primary Specialty: Dentist - General Practice
Enumeration Date: May 15, 2012
Last Updated: May 15, 2012

Practice Location

Address: 108 E GRINNELL ST
City: Sheridan
State: Wyoming
ZIP Code: 82801-3938
Phone: (307) 672-7567

Authorized Official

Name: DR. DONALD E. COON, D.D.S
Title: GENERAL DENTIST/PRESIDENT
Phone: (307) 672-7567

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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