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Organization
LIBERTY LAKE FAMILY DENTISTRY
Active
Organization
LIBERTY LAKE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE R OLMSTEAD DDS (DOCTOR/OWNER)
(509) 891-5001
Entity
Organization
Contact information
Practice address
2207 N MOLTER RD, SUITE 200, LIBERTY LAKE, WA 99019-7570
(509) 891-5001
(509) 891-2787
Mailing address
2207 N MOLTER RD, SUITE 200, LIBERTY LAKE, WA 99019-7570
(509) 891-5001
(509) 891-2787
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008465
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5032438
—
WA
Enumeration date
04/21/2010
Last updated
04/21/2010
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