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Organization

LIVER

Active
Other names
Eleven Eleven Dental
Organization subpart
No

Provider details

NPI number
Authorized official
ETHAN LIVERMONT DDS (OWNER/PARTNER)
(360) 565-5066
Entity
Organization

Contact information

Practice address
1111 COLUMBIA ST, PORT ANGELES, WA 98362-4207
(360) 565-5066
Mailing address
150 W SEQUIM BAY RD, SEQUIM, WA 98382-8406
(360) 565-5066

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
06/17/2026
Last updated
06/17/2026
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