Individual
JEFFREY JAMES LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
800 S WASHINGTON ST, AFTON, WY 83110-9410
(307) 885-4337
Mailing address
800 S WASHINGTON ST, AFTON, WY 83110-9410
(307) 885-4337
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1292
WY
122300000X
Dentist
9197972-9921
UT
1223G0001X
General Practice Dentistry
6979
NE
Other
Enumeration date
07/26/2011
Last updated
12/23/2015
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