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Contact Information

CASPER MOUNTAIN DENTAL DBA ADVANCED FAMILY DENTAL
1431 S. BEVERLY STREET
CASPER, WY82609
 Phone: 307-265-5334
 Fax: 307-265-5336
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for CASPER MOUNTAIN DENTAL DBA ADVANCED FAMILY DENTAL

NPI Number 1164147666
LBN Legal business name CASPER MOUNTAIN DENTAL DBA ADVANCED FAMILY DENTAL
Authorized official AARON LARSEN - (OWNER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/06/2022
Last updated 10/06/2022 - About 4 years ago
Identifiers
WY Medicaid 131751200
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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