NPI: 1164430971 · JACKSON, WY 83002 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 08/04/2006
| Authorized Official | STERN, MICHAEL (PRESIDENT) |
| NPI Enumeration Date | 08/04/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 13 | $600.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D9310 | 13 | 13 | $600.00 |