Individual
RUSSELL JOHN STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
424 N. WARREN AVE., NEWPORT, WA 99156
(509) 447-5960
(575) 572-2259
Mailing address
424 N. WARREN AVE., NEWPORT, WA 99156
(509) 447-5960
(575) 572-2259
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9051997-9921
UT
1223G0001X
General Practice Dentistry
Primary
DE60851015
WA
Other
Enumeration date
10/01/2014
Last updated
07/11/2018
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