Teton Dermatology LLC

NPI #1194044750 in Jackson, Wyoming

Provider Information

NPI Number: 1194044750
Entity Type: Organization
Organization Name: Teton Dermatology LLC
Primary Specialty: Dermatology
Enumeration Date: May 21, 2010
Last Updated: Sep 18, 2024

Practice Location

Address: 984 WEST BROADWAY
Address 2: SUITE 4
City: Jackson
State: Wyoming
ZIP Code: 83001-0000
Phone: (307) 734-1800

Authorized Official

Name: MR. GHEORGHE PUSTA
Title: EXECUTIVE DIRECTOR
Phone: (512) 628-0465

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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