STAR VALLEY ORAL SURGERY is an oral and maxillofacial surgery dentist in Thayne, WY. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. STAR VALLEY ORAL SURGERY NPI is 1821610957. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
487 N MAIN
SUITE B
THAYNE, WY
ZIP 83127
Phone: (307) 883-4222
Fax: (307) 883-4222
The provider's authorized official is Mark Weston Johnson .
The authorized official title is President and has the following contact phone number (307) 883-4222.
The CLIA number assigned to this NPI record is 53D2129489 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 5/12/2020 and was last updated on 5/12/2020.