Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grant Kollenborn

Individual provider General Practice Dentistry · NPI 1548678758

Grant Kollenborn is a General Practice Dentistry in Jackson, Wyoming. Practices as a sole proprietor. Licensed in Louisiana.

Licensed in
LA
In the registry since
2014

Practice location Address checks out

1315 US-89 Ste 102
Jackson, WY 83001
Phone: (307) 733-4122
Fax: (307) 733-4164
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 6488 (LA)

Record details

NPI number1548678758
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 31, 2014
Last updated in NPPESAugust 7, 2026
Certification dateAugust 7, 2026
Mailing addressPo Box 8888, Jackson, WY 83002-8888

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