Provider Demographics
NPI:1255066106
Name:WESTERN SKY DENTAL LLC
Entity type:Organization
Organization Name:WESTERN SKY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ASHDOWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-840-6613
Mailing Address - Street 1:3249 SPARKS RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-6152
Mailing Address - Country:US
Mailing Address - Phone:307-840-6613
Mailing Address - Fax:
Practice Address - Street 1:3249 SPARKS RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-6152
Practice Address - Country:US
Practice Address - Phone:307-840-6613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental