Blacks Fork Dental, PC
Organization Active NPI Dental Clinic/Center · Mt View, WY
NPI 1508322603 · NPPES record last updated Feb 13, 2019
Key facts
- NPI
- 1508322603
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- BLACKS FORK DENTAL, PC
- Practice address
- 650 Parkway Dr
Mt View, WY 82939 - Phone
- (307) 782-3630
- NPI assigned
- Feb 13, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Nathan Ren Lester, DMD
- Title
- President
- Phone
- (307) 782-3630
Practitioners 2
-
Devin Charles Irene, DDS
-
Nathan Ren Lester, DMD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
650 Parkway Dr
Mt View, WY 82939
Mailing address
PO Box 356
Mountain View, WY 82939-0356
Phone (307) 782-3630
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2019. 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.