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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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