Individual
DR. DERRIK PALMER STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
820 OCEAN BEACH HWY, SUITE 110, LONGVIEW, WA 98632-4080
(360) 577-0566
Mailing address
820 OCEAN BEACH HWY, SUITE 110, LONGVIEW, WA 98632-4080
(360) 577-0566
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE 60094586
WA
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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