Advanced Dental, Inc.
Organization Active NPI General Practice Dentistry · Cheyenne, WY
NPI 1770833113 · NPPES record last updated Sep 13, 2012
Key facts
- NPI
- 1770833113
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1302 (WY)
- Legal business name
- ADVANCED DENTAL, INC.
- Practice address
- 7112 Commons Cir
Cheyenne, WY 82009-9999 - Phone
- (970) 685-1371
- NPI assigned
- Sep 13, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Shaun Roger Rocknak, D.D.S.
- Title
- Owner
- Phone
- (970) 685-1371
Practitioners 1
-
Shaun Roger Rocknak, D.D.S.
National Provider Directory
Locations
7112 Commons Cir
Cheyenne, WY 82009
Phone (307) 634-6020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 1302 | WY | Yes |
Addresses
Primary practice location
7112 Commons Cir
Cheyenne, WY 82009-9999
Mailing address
7112 Commons Cir
Cheyenne, WY 82009-9999
Phone (970) 685-1371
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2012. 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.