Dr. Leif Andrew Polson, D.D.S
Dentist in Thermopolis, WY. Individual provider (NPI-1).
NPI number1790737005
StatusActive
Last updated in NPPESAug 20, 2014
Details
- NPI
- 1790737005
- Entity type
- Individual (NPI-1)
- Name
- Dr. Leif Andrew Polson
- Credential
- D.D.S
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 16, 2006
- Last updated
- Aug 20, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 6549 | NE | Yes |
Practice location
110 E Arapahoe StThermopolis, WY 82443-2402
Phone 307-864-9411
Mailing address
110 E Arapahoe StThermopolis, WY 82443-2402
Phone 307-864-9411
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