Organization
JAMES G. LIVINGSTON, DDS.,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GARRY LIVINGSTON DDS (PRESIDENT)
(307) 883-4337
Entity
Organization
Contact information
Practice address
800 WASHINGTON STREET, AFTON, WY 83110-1709
(307) 885-4337
Mailing address
PO BOX 1709, AFTON, WY 83110-1709
(307) 883-4337
(307) 885-4334
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112487100
—
WY
05
—
805327400
—
ID
Enumeration date
07/29/2008
Last updated
07/29/2008
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