Individual
DR. MATTHEW DAVID NORDLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3170 W MACK LN, RATHDRUM, ID 83858-4500
(253) 249-3581
Mailing address
21421 SNAG ISLAND DR E, LAKE TAPPS, WA 98391-8709
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60966868
WA
Other
Enumeration date
08/01/2019
Last updated
08/04/2022
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