Wy Specialty Dental Services, LLC

NPI #1346923133 in Gillette, Wyoming

Provider Information

NPI Number: 1346923133
Entity Type: Organization
Organization Name: Wy Specialty Dental Services, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WY SPECIALTY DENTAL SERVICES, LLC
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Aug 9, 2023
Last Updated: Aug 9, 2023

Practice Location

Address: 2670 OAKCREST DR
City: Gillette
State: Wyoming
ZIP Code: 82718-5905
Phone: (307) 257-8029

Authorized Official

Name: CHARLOTTE DASCH
Title: DIRECTOR OF CREDENTIALING AND PR
Phone: (504) 638-0303

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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