| Star Valley Dental 1 Llc | |
|
725 N Washington St Afton WY 83110-1390 | |
| (307) 885-4355 | |
| Not Available |
| Full Name | Star Valley Dental 1 Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 725 N Washington St, Afton, Wyoming |
| Authorized Official Name and Position | David Hokanson (OWNER) |
| Authorized Official Contact | 3072480741 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Valley Dental 1 Llc Po Box 1390 Afton WY 83110-1390 Ph: (307) 885-4355 | Star Valley Dental 1 Llc 725 N Washington St Afton WY 83110-1390 Ph: (307) 885-4355 |
| NPI Number | 1497394068 |
|---|---|
| Provider Enumeration Date | 12/31/2019 |
| Last Update Date | 12/31/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497394068 | NPI | - | NPPES |
| 137718300 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
James G. Livingston, Dds.,pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Washington Street, Afton, WY 83110 Phone: 307-885-4337 | |
Livingston Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 South Washington St., Afton, WY 83110 Phone: 307-885-4337 Fax: 307-885-4334 | |
Star Valley Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 No Washington Street, Afton, WY 83110 Phone: 307-885-4355 |