Walgren, Bradley K
Walgren, Bradley K is an sole proprietor health care provider with primary practice located at 3421 E Garfield , Laramie WY 82070. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Walgren, Bradley K can be contacted via phone (307) 745-8513.Contact Information
Primary practice address
3421 E Garfield
Laramie WY 82070
Phone: (307) 745-8513
Fax: (307) 745-0263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 921 | Wyoming |
Profile Details
| NPI number | 1093749145 |
|---|---|
| LBN Legal business name | Walgren, Bradley K |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Feb 16th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093749145 | NPPES |
| Wyoming | MEDICAID | 112311400 |
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