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1144568924
CLYDE WALLACE STOCK
FREEDOM, WY
NPI
1144568924
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
204E00000X Oral & Maxillofacial Surgery
(Licence: WY 472)
Enumeration Date
2013-01-29
Last Update Date
2013-01-29
Business Address
Dr. CLYDE WALLACE STOCK D.D.S.
156 COUNTY ROAD 114
FREEDOM, WY 83120
Phone number: 307-880-2760
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Mailing Address
Dr. CLYDE WALLACE STOCK D.D.S.
PO BOX 227
FREEDOM, WY 83120
Phone number: 307-880-2760
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