Individual
DR. RUSSELL ADELBERT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7825 47TH AVE NE, SUITE C, MARYSVILLE, WA 98270-3732
(360) 657-7785
(360) 657-5696
Mailing address
7825 47TH AVE NE, SUITE C, MARYSVILLE, WA 98270-3732
(360) 657-7785
(360) 657-5696
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6917
WA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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