| Dr Michael J Wine, DDS | |
|
610 W Broadway Ave, Jackson, WY 83001-8213 | |
| (307) 732-2273 | |
| (307) 732-1660 |
| Full Name | Dr Michael J Wine |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 610 W Broadway Ave, Jackson, Wyoming |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245353168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1325 (Wyoming) | Primary |
| 122300000X | Dentist | D 4424 (Idaho) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael J Wine, DDS 6797 Shire Ridge Dr, Victor, ID 83455-5036 Ph: (614) 648-6657 | Dr Michael J Wine, DDS 610 W Broadway Ave, Jackson, WY 83001-8213 Ph: (307) 732-2273 |
Dr. Veldon Ross Moser, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1115 Maple Way, Jackson, WY 83001 Phone: 307-733-7044 Fax: 307-734-1409 | |
Dr. Michael Stern, D.M.D, PHD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1160 Alpine Ln, Suite 1d, Jackson, WY 83001 Phone: 307-739-8611 Fax: 307-739-8613 | |
Dr. Catherine M Tebay, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1325 S. Hwy 89, Suite 107, Jackson, WY 83002 Phone: 307-734-5665 Fax: 307-734-6066 | |
Dr. Rebecca E. Cloetta, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1315 S Hwy 89, Suite 102, Jackson, WY 83002 Phone: 307-733-4122 Fax: 307-733-4164 | |
Dr. Nathan John Tanner, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 200 E Broadway Ave # 1190, Jackson, WY 83001 Phone: 307-733-5222 | |
Dr. Scott Coburn Larsen, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 245 E Broadway, Jackson, WY 83001 Phone: 307-733-4778 Fax: 307-734-8041 |