Provider Demographics
NPI:1902946932
Name:STEPHEN P & KAREN CHEEK PTR
Entity Type:Organization
Organization Name:STEPHEN P & KAREN CHEEK PTR
Other - Org Name:KEMMERER DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHEEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-877-6951
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:DIAMONDVILLE
Mailing Address - State:WY
Mailing Address - Zip Code:83116-0314
Mailing Address - Country:US
Mailing Address - Phone:307-877-6951
Mailing Address - Fax:307-877-4149
Practice Address - Street 1:100 CANYON ROAD
Practice Address - Street 2:
Practice Address - City:DIAMONDVILLE
Practice Address - State:WY
Practice Address - Zip Code:83116-0314
Practice Address - Country:US
Practice Address - Phone:307-877-6951
Practice Address - Fax:307-877-4149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty