Doctor Name: | DENISE R PRUGH |
NPI Number: | 1003921735 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DDS |
License Number: | 964 |
Business Practice Address: | 295 N Walsh Dr Casper, WY - 826091911 |
Business Phone Number: | 3072657878 |
Business Fax Number: | |
Mailing Address: | 295 N Walsh Dr, CASPER |
State: | WY |
Postal Code: | 826091911 |
Phone Number: | 3072657878 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 964 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WY |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |