Provider Demographics
NPI:1447562012
Name:VISION AYUDA, INC.
Entity Type:Organization
Organization Name:VISION AYUDA, INC.
Other - Org Name:PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-854-3244
Mailing Address - Street 1:1439 STILLWATER AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-7367
Mailing Address - Country:US
Mailing Address - Phone:307-778-7100
Mailing Address - Fax:
Practice Address - Street 1:1439 STILLWATER AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-7367
Practice Address - Country:US
Practice Address - Phone:307-778-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY12451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty