Provider Demographics
NPI:1346440534
Name:JEFFRIES, KAMME LYNNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAMME
Middle Name:LYNNE
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 PAINTBRUSH LANE
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401
Mailing Address - Country:US
Mailing Address - Phone:307-347-3994
Mailing Address - Fax:307-347-3697
Practice Address - Street 1:3313 PAINTBRUSH LANE
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401
Practice Address - Country:US
Practice Address - Phone:307-347-3994
Practice Address - Fax:307-347-3697
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice