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General NPI Number Information
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NPI Number | 1467970772
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Entity Type | Organization
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Legal Business Name | SLEEP BETTER WYOMING LLC
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 09/07/2017
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Provider Practice Location Address
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Address Line | 661 UINTA DR
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City | GREEN RIVER
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State | WY
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Zip | 82935-5056
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Country | US
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Telephone | 307-875-3658
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Fax | 307-875-3660
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Provider Business Mailing Address
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Address Line | PO BOX 309
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City | GREEN RIVER
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State | WY
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Zip | 82935-0309
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Country | US
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Telephone | 307-875-3658
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Fax | 307-875-3660
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. BRYANT P BIRCH
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Credential | DDS, PC
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Telephone | 307-871-6832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 1149
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License Number State | WY
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