River District Modern Dentistry Pllc
NPI #1215685599 in Liberty Lake, Washington
Provider Information
- NPI Number
- 1215685599
- Entity Type
- Organization
- Organization Name
- River District Modern Dentistry Pllc
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Mar 15, 2022
- Last Updated
- Mar 7, 2023
Practice Location
- Address
- 21808 E INDIANA AVE
- City
- Liberty Lake
- State
- Washington
- ZIP Code
- 99019-4004
- Phone
- (509) 408-5080
Authorized Official
- Name
- DR. MARK BRADLE, DMD
- Title
- OWNER
- Phone
- (509) 408-5080
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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