Individual
JAMIE JIVIDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
619 IRISH HOLW, SMETHPORT, PA 16749-4115
(814) 596-3172
Mailing address
619 IRISH HOLW, SMETHPORT, PA 16749-4115
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH068273
PA
Other
Enumeration date
10/27/2025
Last updated
10/27/2025
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