NPI 1144568924

Clyde Wallace Stock, DDS

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Freedom, WY

Practice location

Address: 156 County Road 114, Freedom, WY 83120
Phone: (307) 880-2760
Mailing address: PO Box 227, Freedom, WY 83120

Registered specialties

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 472 (WY)

Other Oral & Maxillofacial Surgery providers in Wyoming →

Registry record

NPI: 1144568924
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jan 2013
Record last updated: 29 Jan 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.