Harold Macon, DDS
Individual provider Active NPI General Practice Dentistry · Riverton, WY
NPI 1104065903 · NPPES record last updated Feb 18, 2009
Key facts
- NPI
- 1104065903
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 464 (WY)
- Practice address
- 1224 E Jackson Ave
Riverton, WY 82501-3841 - Phone
- (307) 856-3463
- Fax
- (307) 856-9910
- NPI assigned
- Feb 18, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 464 | WY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverton Smiles | General Practice | Past | Accepting new patients |
| Dental Care of Fremont County | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 464 | WY | Yes |
Addresses
Primary practice location
1224 E Jackson Ave
Riverton, WY 82501-3841
Mailing address
1224 E Jackson Ave
Riverton, WY 82501-3841
Phone (307) 856-3463
Other providers in Riverton, WY
- Thomas G Loften
- Red Dawn Lopez
- Michelle Luoma
- Rory Luther
- Dawn Renee' Mabrouk
- Timalee Madson
- Magellan Healthcare of Wyoming
- Mike Mahoney
- Paula Lynne Markowski
- Tonya Dawn Martin
All providers in Riverton, WY · General Practice Dentistry in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.