Gregg Liedtka Dmd Pllc

NPI #1831683168 in Odessa, Washington

Provider Information

NPI Number: 1831683168
Entity Type: Organization
Organization Name: Gregg Liedtka Dmd Pllc
Primary Specialty: Dentist
Enumeration Date: Jun 20, 2018
Last Updated: Jul 3, 2018

Practice Location

Address: 20 W 1ST AVE
City: Odessa
State: Washington
ZIP Code: 99159
Phone: (209) 982-2605

Authorized Official

Name: MRS. NINA STEWART
Title: ADMINISTRATIVE ASSISTANT
Phone: (520) 431-4313

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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