# CASEY FAMILY DENTAL DDS, PS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Liberty Lake Smile Source
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568926046
- **Authorized official:** LORI A CHRISTOPHERSON (OFFICE MANAGER)
- **Authorized official phone:** (509) 927-9279

## Contact information

- **Practice address:** 22011 E COUNTRY VISTA DR STE 201, LIBERTY LAKE, WA 99019-5242
- **Practice address phone:** (509) 927-9279
- **Practice address fax:** (509) 927-9278
- **Mailing address:** 22011 E COUNTRY VISTA DR STE 201, LIBERTY LAKE, WA 99019-5242
- **Mailing address phone:** (509) 927-9279
- **Mailing address fax:** (509) 927-9278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/29/2019
- **Last updated:** 12/30/2020