Healthcare Provider Details

I. General information

NPI: 1932026614
Provider Name (Legal Business Name): A NEW YOU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S. MAIN STREET
BUFFALO WY
82834-2177
US

IV. Provider business mailing address

PO. BOX 126
BUFFALO WY
82834-2117
US

V. Phone/Fax

Practice location:
  • Phone: 307-684-2733
  • Fax: 307-684-2437
Mailing address:
  • Phone: 307-684-2733
  • Fax: 307-684-2437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN JEROME COTANT
Title or Position: DENTIST
Credential: DDS
Phone: 307-684-2733