Clubhouse Pediatric Dentistry Of Jackson

LBN: Clubhouse Pediatric Dentistry Of Jackson
Clubhouse Pediatric Dentistry Of Jackson is an health care organization with primary practice located at 1130 Us-89 , Jackson Hole WY 83001-8701. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Clubhouse Pediatric Dentistry Of Jackson can be contacted via phone (307) 733-5439, or through Jackson, Courtney Matthew via phone (307) 733-5439.

Contact Information

Primary practice address
1130 Us-89 Jackson Hole WY 83001-8701
Phone: (307) 733-5439
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Courtney Matthew Doctor of Dental Surgery (DDS)
Phone: (307) 733-5439

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1942775960
LBN Legal business name Clubhouse Pediatric Dentistry Of Jackson
DBA Doing business as
Authorized official Jackson, Courtney Matthew Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 5th, 2018
Last updated Oct 5th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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