Elk Ridge Dental
Dentist, General Practice in Jackson, WY. Organization (NPI-2).
NPI number1497845127
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1497845127
- Entity type
- Organization (NPI-2)
- Legal business name
- Elk Ridge Dental
- Organization subpart
- No
- Enumeration date
- Oct 13, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 1083 | WY | Yes |
Other names
- Elkridge Dental (Doing Business As)
Practice location
200 East BroadwayJackson, WY 83001
Phone 307-733-2555 · Fax 307-733-2552
Mailing address
Po Box 1190Jackson, WY 83001-1190
Authorized official
Aaron Galbraith
Owner
3077332555
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