# PACKARD SORENSON AND MILLER P.L.L.C

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

## Provider details

- **NPI number:** 1912489659
- **Authorized official:** DR. OWEN EARL PACKARD DDS (OWNER)
- **Authorized official phone:** (509) 922-2211

## Contact information

- **Practice address:** 1612 N BARKER RD STE 100, SPOKANE VALLEY, WA 99016-5036
- **Practice address phone:** (509) 922-2211
- **Practice address fax:** (509) 764-0886
- **Mailing address:** 1612 N BARKER RD STE 100, SPOKANE VALLEY, WA 99016-5036
- **Mailing address phone:** (509) 764-0307
- **Mailing address fax:** (509) 764-0886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/29/2018
- **Last updated:** 10/18/2018