Provider Demographics
NPI:1083733174
Name:YOUMANS, STUART M (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:M
Last Name:YOUMANS
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 S. CONWELL ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601
Mailing Address - Country:US
Mailing Address - Phone:307-234-6054
Mailing Address - Fax:307-234-7896
Practice Address - Street 1:1122 S CONWELL ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3965
Practice Address - Country:US
Practice Address - Phone:307-234-6054
Practice Address - Fax:307-234-7896
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice