| Liberty Lake Dental Care | |
|
23403 E Mission Ave Suite C Liberty Lake WA 99019-7553 | |
| (509) 893-1119 | |
| Not Available |
| Full Name | Liberty Lake Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23403 E Mission Ave, Liberty Lake, Washington |
| Authorized Official Name and Position | C Ross Simonds (PRESIDENT) |
| Authorized Official Contact | 5098931119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Lake Dental Care 23403 E Mission Ave Suite C Liberty Lake WA 99019-7553 Ph: (509) 893-1119 | Liberty Lake Dental Care 23403 E Mission Ave Suite C Liberty Lake WA 99019-7553 Ph: (509) 893-1119 |
| NPI Number | 1982790630 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982790630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE00008443 (Washington) | Primary |
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