Individual
DANE ST. JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
707 SHERIDAN AVE, CODY, WY 82414
(307) 578-2500
(307) 578-2492
Mailing address
707 SHERIDAN AVE, CODY, WY 82414
(307) 578-2500
(307) 578-2492
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
27461
AL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9197A
WY
Other
Enumeration date
05/21/2007
Last updated
04/12/2013
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