Individual
GEOFFREY A STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1602 NW HUGHWOOD CT, ROSEBURG, OR 97470-8844
(541) 672-2872
(541) 672-6885
Mailing address
1602 NW HUGHWOOD CT, ROSEBURG, OR 97470-8844
(541) 672-2872
(541) 672-6885
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5542
OR
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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