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.
Organization
MC-LL LLC
Active
Organization
MC-LL LLC
Active
Other names
Mint Condition Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARSHALL F GIBBS DDS (OWNER)
(509) 235-2900
Entity
Organization
Contact information
Practice address
21801 E COUNTRY VISTA DR, STE 105, LIBERTY LAKE, WA 99019
(509) 926-5272
(509) 926-4855
Mailing address
PO BOX 19187, SPOKANE, WA 99219
(509) 926-5272
(509) 926-4855
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10993
WA
1223G0001X
General Practice Dentistry
Primary
8440
WA
1223G0001X
General Practice Dentistry
8853
WA
1223G0001X
General Practice Dentistry
DE60240234
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5055470
—
WA
Enumeration date
05/18/2006
Last updated
06/19/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers