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Organization

RUSSELL A. BARRON, DDS, INC, PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RUSSELL ALLEN BARRON DDS (CEO)
(360) 629-2420
Entity
Organization

Contact information

Practice address
9619 271ST ST NW, STANWOOD, WA 98292-0819
(360) 629-2420
(360) 629-7211
Mailing address
PO BOX 819, STANWOOD, WA 98292-0819
(360) 629-2420
(360) 629-7211

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00003899
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0151502
L & I REGULAR PROVIDER #
WA
05
5320205
WA
05
8004236
WA
01
8924064
L & I CRIME VICTIMS PROV#
WA
Enumeration date
03/19/2007
Last updated
11/19/2009
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