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Organization
ASPEN HILLS DENTAL LLC
Active
Organization
ASPEN HILLS DENTAL LLC
Active
Other names
Livingston Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEANELLE ELMOYNE LIVINGSTON RN (OPERATIONS LEADER)
(307) 885-4337
Entity
Organization
Contact information
Practice address
800 SOUTH WASHINGTON ST., AFTON, WY 83110
(307) 885-4337
(307) 885-4334
Mailing address
800 SOUTH WASHINGTON ST., 800 SOUTH WASHINGTON, AFTON, WY 83110
(307) 885-4337
(307) 885-4334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
910
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112487100
—
WY
Enumeration date
10/16/2014
Last updated
04/06/2017
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