Lander Dental Group,pc

NPI #1902098528 in Lander, Wyoming

Provider Information

NPI Number: 1902098528
Entity Type: Organization
Organization Name: Lander Dental Group,pc
Subpart: Yes (part of a larger organization)
Parent Organization: LANDER DENTAL GROUP, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 16, 2007
Last Updated: Nov 20, 2014

Practice Location

Address: 799 S 2ND ST
City: Lander
State: Wyoming
ZIP Code: 82520-3703
Phone: (307) 332-7710

Authorized Official

Name: CHRIS R PETERSON, DDS
Title: PRESIDENT
Phone: (307) 332-7710

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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