| Pinedale Dental | |
|
33 Fremont Lake Rd Pinedale WY 82941-5213 | |
| (307) 367-3700 | |
| (307) 312-2848 |
| Full Name | Pinedale Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 33 Fremont Lake Rd, Pinedale, Wyoming |
| Authorized Official Name and Position | Alison Petersen (RECEPTIONIST) |
| Authorized Official Contact | 3073673700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinedale Dental Po Box 1190 Pinedale WY 82941-1190 Ph: (307) 367-3700 | Pinedale Dental 33 Fremont Lake Rd Pinedale WY 82941-5213 Ph: (307) 367-3700 |
| NPI Number | 1033870779 |
|---|---|
| Provider Enumeration Date | 01/05/2022 |
| Last Update Date | 01/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033870779 | NPI | - | NPPES |
| 207753100 | Medicaid | WY | |
| 113694100 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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