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General NPI Number Information
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NPI Number | 1255416459
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Entity Type | Individual
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Provider Name | STONE RANGARAJAN THAYER DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 134 MENGER SPGS STE 1200
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City | BOERNE
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State | TX
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Zip | 78006-7220
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Country | US
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Telephone | 830-815-2480
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Fax |
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Provider Business Mailing Address
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Address Line | 134 MENGER SPGS STE 1200
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City | BOERNE
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State | TX
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Zip | 78006-7220
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Country | US
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Telephone | 830-815-2480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN 20469
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | A137085
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | ME 114524
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22911
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License Number State | TX
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