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Individual

DR. RUSSELL ARON LIEBLICK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
24850 SE STARK ST, SUITE 100, GRESHAM, OR 97030-8316
(503) 665-7882
(503) 665-6983
Mailing address
24850 SE STARK ST, SUITE 100, GRESHAM, OR 97030-8316
(503) 665-7882
(503) 665-6983

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D8342
OR

Other

Enumeration date
07/22/2005
Last updated
07/08/2007
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