Individual
RUSSELL MCCLAIN GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
308 WEST ST LOUIS ST, HOT SPRINGS, AR 71913-4406
(501) 321-1977
(501) 321-1750
Mailing address
308 WEST ST LOUIS ST, HOT SPRINGS, AR 71913
(501) 321-1977
(501) 321-1750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AR3238
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T948
BCBS
AR
01
—
975194
UNITED CONCORDIA
AR
Enumeration date
01/16/2007
Last updated
07/08/2007
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