| Liberty Lake Family Dentistry | |
|
2207 N Molter Rd Suite 200 Liberty Lake WA 99019-7570 | |
| (509) 891-5001 | |
| (509) 891-2787 |
| Full Name | Liberty Lake Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2207 N Molter Rd, Liberty Lake, Washington |
| Authorized Official Name and Position | Michelle R Olmstead (DOCTOR/OWNER) |
| Authorized Official Contact | 5098915001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Lake Family Dentistry 2207 N Molter Rd Suite 200 Liberty Lake WA 99019-7570 Ph: (509) 891-5001 | Liberty Lake Family Dentistry 2207 N Molter Rd Suite 200 Liberty Lake WA 99019-7570 Ph: (509) 891-5001 |
| NPI Number | 1255658886 |
|---|---|
| Provider Enumeration Date | 04/21/2010 |
| Last Update Date | 04/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255658886 | NPI | - | NPPES |
| 5032438 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE00008465 (Washington) | Primary |
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