# LIEBOLD DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Liebold Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316483050
- **Authorized official:** DAVID A. LIEBOLD DDS (DIRECTOR)
- **Authorized official phone:** (701) 228-2200

## Contact information

- **Practice address:** 210 11TH ST E, BOTTINEAU, ND 58318-2052
- **Practice address phone:** (701) 228-2200
- **Practice address fax:** (701) 228-2222
- **Mailing address:** PO BOX 369, BOTTINEAU, ND 58318-0369
- **Mailing address phone:** (701) 228-2200
- **Mailing address fax:** (701) 228-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | ND1758 | ND | Yes |

## Other

- **Enumeration date:** 01/18/2017
- **Last updated:** 01/18/2017