| Doctor Name: | DR. TRISTAN VAUN STONGER |
| NPI Number: | 1134213796 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 4581 |
| Business Practice Address: | 1 S Broadway Peru, IN - 469702231 |
| Business Phone Number: | 7654325294 |
| Business Fax Number: | 7654727700 |
| Mailing Address: | 1 S Broadway, PERU |
| State: | IN |
| Postal Code: | 469702231 |
| Phone Number: | 7654325294 |
| Fax Number: | 7654727700 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 12/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 4581 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |