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Organization
TETON ORAL & MAXILLOFACIAL SURGERY
Active
Organization
TETON ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STERN DMD PHD (PRESIDENT)
(307) 739-8611
Entity
Organization
Contact information
Practice address
1160 ALPINE LANE, #1D, JACKSON, WY 83002
(307) 739-8611
(307) 739-8613
Mailing address
PO BOX 9339, JACKSON, WY 83002-9339
(307) 739-8611
(307) 739-8613
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
08/04/2006
Last updated
07/26/2018
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