Individual
EDWARD CLARK STURDIVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1119 LAWRENCE STREET, PORT TOWNSEND, WA 98368-2224
(360) 385-5121
Mailing address
1119 LAWRENCE STREET, PORT TOWNSEND, WA 98368-2224
(360) 385-5121
(360) 379-9534
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00004262
WA
Other
Enumeration date
11/09/2011
Last updated
11/09/2011
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