=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326059791
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WORLAND DENTAL CLINIC, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2006
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 209 SOUTH 7TH ST
-----------------------------------------------------
City | WORLAND
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-347-2544
-----------------------------------------------------
Fax | 307-347-2352
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 209 S 7TH ST
-----------------------------------------------------
City | WORLAND
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82401-3307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-347-2544
-----------------------------------------------------
Fax | 307-347-2352
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MELISSA BAKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 307-347-2544
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 573
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 1118
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------