Individual
DR. DAVID ALLAN LIEBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
621 MAIN ST, BOTTINEAU, ND 58318-1344
(701) 228-2200
Mailing address
621 MAIN ST, BOTTINEAU, ND 58318-1344
(701) 228-2200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
ND1758
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41105
—
ND
Enumeration date
02/06/2007
Last updated
07/08/2007
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