Provider Demographics
NPI:1265727150
Name:MAURER, JAROM E (DMD)
Entity type:Individual
Prefix:DR
First Name:JAROM
Middle Name:E
Last Name:MAURER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4535 VALLEY COMMONS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-4161
Mailing Address - Country:US
Mailing Address - Phone:406-551-2816
Mailing Address - Fax:
Practice Address - Street 1:4535 VALLEY COMMONS DR STE 102
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-4161
Practice Address - Country:US
Practice Address - Phone:406-551-2816
Practice Address - Fax:406-551-2813
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK63131223S0112X
IADDS-091731223S0112X
MT155331223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery