DR. CLYDE WALLACE STOCK (NPI# 1144568924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144568924 |
| Entity Type | Individual |
| Full Name | DR. CLYDE WALLACE STOCK |
| Credential | D.D.S. |
| Practice Address |
156 County Road 114 Freedom WY 83120 |
| Mailing Address |
Po Box 227 Freedom WY 83120 |
| Practice Telephone | 3078802760 |
| Mailing Telephone | 3078802760 |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 472 | WY | Allopathic & Osteopathic Physicians |
| Street Address |
156 COUNTY ROAD 114 |
| City | FREEDOM |
| State | WY |
| Zip Code | 83120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932604 | Cassie Mae Mathis | Prosthetic/Orthotic Supplier | W1643 Greiner Rd, Freedom, WI 54130-7943 | 2020-11-03 |
| 1245843267 | Kendall Thiry | Occupational Therapist | N2740 French Rd, Freedom, WI 54913-8919 | 2020-08-28 |
| 1942828116 | Sarah Hager | Registered Nurse | 8368 Higgins Rd, Freedom, NY 14065-9529 | 2020-07-13 |
| 1033742523 | Joni Lynn Bender | Home Health | 109 Pinehurst Dr, Freedom, PA 15042-2523 | 2020-02-13 |
| 1053954925 | Katie Mccabe | Home Health | 150 Village Rd, Freedom, NH 03836-4937 | 2019-10-23 |
| 1245881788 | Michael A Irete | Technician | 2030 Pajaro Ln Apt 4108, Freedom, CA 95019-2930 | 2019-09-26 |
| 1649757428 | J. B. Physical Therapy, Inc. | Physical Therapist | 212 Green Valley Road, Freedom, CA 95019 | 2018-07-24 |
| 1861987059 | Encompass Community Services | Community/Behavioral Health | 2714 Freedom Blvd., Freedom, CA 95076 | 2018-06-29 |
| 1891287975 | Ver Voort Chiropractic | Chiropractor | N4083 County Rd E Ste B, Freedom, WI 54130-7595 | 2018-06-04 |
| 1104316694 | Rebecca Graham | Registered Nurse | 10054 Sandbank Rd, Freedom, NY 14065-9759 | 2018-05-10 |
| Find all providers in FREEDOM | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.