OrganizationActive
Teton Oral and Maxillofacial Surgery
NPI 1740776202 · Oral & Maxillofacial Surgery (D.M.D.) · Jackson, WY
Provider details
- NPI number
- 1740776202
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Bridget Mullen, Office Manager(307) 690-1513
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Oral and Maxillofacial Surgery (Dentist)1223S0112X
Dental Providers
Practice location
1160 Alpine Ln Ste 1d
Jackson, WY 83001
Phone: (307) 739-8611
Fax: (307) 739-8613
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 9339
Jackson, WY 83002-9339
Registry dates
- Enumerated
- 2018-07-09
- Last updated
- 2018-07-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.