Provider Demographics
NPI:1639647589
Name:BRIANT ROMNEY DDS
Entity Type:Organization
Organization Name:BRIANT ROMNEY DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIANT
Authorized Official - Middle Name:STRINGHAM
Authorized Official - Last Name:ROMNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-349-3308
Mailing Address - Street 1:140 DUPONT DR
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-3055
Mailing Address - Country:US
Mailing Address - Phone:801-643-8718
Mailing Address - Fax:307-332-2295
Practice Address - Street 1:850 MAIN ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3038
Practice Address - Country:US
Practice Address - Phone:307-349-3308
Practice Address - Fax:307-332-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty