Individual
DR. MARK WILLIAM BOTTORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
323 S. GREENRIDGE DR., LIBERTY LAKE, WA 99019
(509) 808-9766
(509) 891-8999
Mailing address
1324 N. LIBERTY LAKE RD, STE 345, LIBERTY LAKE, WA 99019
(509) 808-9766
(509) 891-8999
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
DE00009793
WA
1223D0004X
Dental Anesthesiology
GA10000366
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20069362
—
WA
Enumeration date
05/03/2007
Last updated
08/04/2025
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