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General NPI Number Information
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NPI Number | 1619434313
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Entity Type | Organization
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Legal Business Name | CHILDRENS DENTAL CENTER OF ROCK SPRINGS
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 1208 HILLTOP DR STE 209
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5860
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Country | US
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Telephone | 307-362-3395
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Fax |
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Provider Business Mailing Address
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Address Line | 1208 HILLTOP DR STE 209
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5860
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Country | US
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Telephone | 586-719-2341
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. WESTON JONES
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Credential | DMD
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Telephone | 307-362-3395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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