MEDICARE: DANIEL J LIVINGSTON DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	037100	NY

General Provider Information

NPI Number	:	1215364583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL J LIVINGSTON DDS PC

Provider Business Mailing Address
First Line	:	2104 E HENRIETTA RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4518
Country	:	US
Telephone Number	:	585-334-8350
Fax Number	:	585-334-0390

Provider Business Practice Location Address
First Line	:	2104 E HENRIETTA RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4518
Country	:	US
Telephone Number	:	585-334-8350
Fax Number	:	585-334-0390

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL J LIVINGSTON
Credential	:	DDS
Telephone Number	:	585-334-8350

Provider Enumeration Date	:	10/02/2013
Last Update Date	:	10/02/2013

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