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Individual

MRS. CLARISSA MARY SPARKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D

Contact information

Practice address
802 W 42ND ST, HIBBING, MN 55746-3222
(218) 263-8381
(218) 263-8383
Mailing address
802 W 42ND ST, HIBBING, MN 55746-3222
(218) 263-8381
(218) 263-8383

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13098
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518086750
MN
05
40058
ND
Enumeration date
06/15/2012
Last updated
09/02/2016
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