NPI | 1982790630 |
---|---|
Doing Business As | LIBERTY LAKE DENTAL CARE |
Entity Type | Organization |
Authorized Contact | C ROSS SIMONDS President 509-893-1119 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008443) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2020-08-22 |