RUSSELL D BLACKHURST

MISSOULA, MT
NPI1801080015
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: MT  2306)
Additional Taxonomies122300000X Dentist
(Licence: CO  9453)
Enumeration Date2007-08-30
Last Update Date2011-08-11
Business Address
Dr. RUSSELL D BLACKHURST D.M.D.
913 SW HIGGINS AVE 201
MISSOULA, MT 59803-1461
Phone number: 406-721-2686
Mailing Address
Dr. RUSSELL D BLACKHURST D.M.D.
913 SW HIGGINS AVE 201
MISSOULA, MT 59803-1461
Phone number: 406-721-2686