Jd Online LLC
NPI #1588408504 in Liberty Lake, Washington
Provider Information
- NPI Number
- 1588408504
- Entity Type
- Organization
- Organization Name
- Jd Online LLC
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Jun 24, 2024
- Last Updated
- Jun 24, 2024
Practice Location
- Address
- 23403 E MISSION AVE
- Address 2
- SUITE 217
- City
- Liberty Lake
- State
- Washington
- ZIP Code
- 99019
- Phone
- (509) 645-2640
Authorized Official
- Name
- DR. JARED DEAN EVANS, DMD
- Title
- DENTIST
- Phone
- (509) 389-9333
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
| Exclusive Provider Organization |
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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