BLACKS FORK DENTAL, PC (NPI# 1508322603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508322603 |
| Entity Type | Organization |
| Organization Name | BLACKS FORK DENTAL, PC |
| Practice Address |
650 Parkway Dr Mt View WY 82939 |
| Mailing Address |
Po Box 356 Mountain View WY 82939-0356 |
| Practice Telephone | 3077823630 |
| Mailing Telephone | 3077823630 |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-13 |
| Authorized Official Name | DR. NATHAN REN LESTER (PRESIDENT) |
| Authorized Official Telephone | 3077823630 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
650 PARKWAY DR |
| City | MT VIEW |
| State | WY |
| Zip Code | 82939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013568922 | Paul R Burpo Jr. | Pharmacist | 950 N Hwy 414, Mountain View, WY 82939 | 2019-09-23 |
| 1770043234 | Bvp LLC | Pharmacy | 950 N. Hwy 414, Mountain View, WY 82939 | 2019-03-21 |
| 1073062774 | Kirstin Dennis | Speech-Language Pathologist | 1001 Hwy 414 North, Mountain View, WY 82939 | 2016-09-23 |
| 1639525702 | Alliance Case Management | Case Manager/Care Coordinator | 657 Parkway Dr., Mountain View, WY 82939 | 2016-05-09 |
| 1609175405 | Sandra Lee Jones | Case Manager/Care Coordinator | 210 Riverbend Drive, Mountain View, WY 82939 | 2011-03-18 |
| 1184922007 | Jeffery La Von Walker | Case Manager/Care Coordinator | 210 Riverbend Dr., Mountain View, WY 82939 | 2011-03-01 |
| 1992034128 | Lincoln Uinta Child Development Association | Case Management | 1050 Highway 414, Mountain View, WY 82939 | 2009-12-17 |
| 1548599970 | Susan Parkinson | Case Manager/Care Coordinator | 3284 Aspen Lane, Box 969, Mountain View, WY 82939 | 2009-12-14 |
| 1356572101 | Steven Wayne Babcock | Family Medicine | 531 Parkway Drive, Mountain View, WY 82939 | 2009-07-28 |
| 1124272372 | Timberland Chiropractic PC | Chiropractor | 1050 N Hwy 414, Mountain View, WY 82939 | 2008-11-13 |
| Find all providers in zip 82939 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
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|---|---|---|---|---|
| 1619503349 | Alpine Denitstry | Clinic/Center | 945 W Broadway Ave Apt 201, Jackson, WY 83001-8217 | 2020-03-13 |
| 1497394068 | Star Valley Dental 1 LLC | Clinic/Center | 725 N Washington St, Afton, WY 83110-1390 | 2019-12-31 |
| 1467090571 | Scott Dental LLC | Clinic/Center | 1212 S. River Street, Saratoga, WY 82331 | 2019-12-19 |
| 1033699533 | Oak Haven Dental | Clinic/Center | 8125 State Highway 789, Lander, WY 82520-2926 | 2018-08-15 |
| 1801337902 | Dental Arts PC | Clinic/Center | 3421 E Garfield St, Laramie, WY 82070-5163 | 2017-03-09 |
| 1669916334 | Braces U Wyoming PC | Clinic/Center | 6900 Yellowtail Rd Ste 100, Cheyenne, WY 82009-6102 | 2016-12-14 |
| 1972863207 | Bingham Endodontics, Pllc | Clinic/Center | 610 W. Broadway Ave, Jackson, WY 83001 | 2012-05-21 |
| 1003069865 | Wyoming Cosmetic and Family Dental | Clinic/Center | 4620 Grandview Ave, Cheyenne, WY 82009-4963 | 2008-10-24 |
| 1467561167 | Bozeman Trail Orthodontics PC | Clinic/Center | 932 South David St, Casper, WY 82601 | 2006-08-29 |
| 1780207811 | Graham Family Dental | Clinic/Center | 325 W Main St Ste G, Riverton, WY 82501-3448 | 2020-05-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.