Bear River Dental

NPI #1649575465 in Evanston, Wyoming

Provider Information

NPI Number: 1649575465
Entity Type: Organization
Organization Name: Bear River Dental
Primary Specialty: Dentist
Enumeration Date: Jan 26, 2011
Last Updated: Jan 26, 2011

Practice Location

Address: 50 PARK RD
City: Evanston
State: Wyoming
ZIP Code: 82930-2613
Phone: (307) 789-5608

Authorized Official

Name: NATHAN R LESTER, DMD
Title: OWNER
Phone: (307) 789-5608

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dentist	122300000X	Primary

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