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General NPI Number Information
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NPI Number | 1265596084
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Entity Type | Individual
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Provider Name | JOHN RICHARD MCPHERSON DDS
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 204 MCCOLLUM ST SUITE 203
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City | LARAMIE
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State | WY
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Zip | 82070-5103
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Country | US
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Telephone | 307-742-2328
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Fax | 307-742-0543
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Provider Business Mailing Address
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Address Line | 1408 MITCHELL ST
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City | LARAMIE
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State | WY
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Zip | 82072-2271
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Country | US
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Telephone | 307-745-8170
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Fax | 307-742-0543
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | WY 1100
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License Number State | WY
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