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Diamond G Dental LLC

NPI #1205291242 in Kemmerer, Wyoming

Provider Information

NPI Number
1205291242
Entity Type
Organization
Organization Name
Diamond G Dental LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Dec 17, 2015
Last Updated
Dec 29, 2015

Practice Location

Address
1702 ANTELOPE STREET
City
Kemmerer
State
Wyoming
ZIP Code
83101-4049
Phone
(307) 877-4715

Authorized Official

Name
STEPHEN BRAD GRANDY, DDS
Title
PRESIDENT
Phone
(307) 723-0448

Specialties & Taxonomy Codes

Specialty
Dentist - General Practice — General Practice

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