BLACKS FORK DENTAL, PC; NPI #1508322603

Contact Information

BLACKS FORK DENTAL, PC

650 PARKWAY DR
MT VIEW, WY 82939

Phone: 307-782-3630
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for BLACKS FORK DENTAL, PC

NPI #	`1508322603`
LBN Legal business name	BLACKS FORK DENTAL, PC
Authorized official	NATHAN LESTER - (PRESIDENT)
Entity	Organization
Organization subpart ¹	No
Enumeration date	02/13/2019
Last updated	02/13/2019 - About 7 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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