Individual
DR. MICHAEL STERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D, PHD
Contact information
Practice address
1160 ALPINE LN, SUITE 1D, JACKSON, WY 83001
(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)
Primary
1037
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119386400
—
WY
Enumeration date
01/28/2009
Last updated
01/28/2009
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