Individual
CLINTON RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS035819
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101136688
—
PA
Enumeration date
08/31/2005
Last updated
08/11/2008
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