Jerry R Clark DDS, MS

NPI 1619203551 - Dentist - 1223X0400X

NPI Details
NPI 1619203551
Gender Male
Enumeration Date 10/28/2009
Last Updated 10/28/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
1115 W FRIENDLY AVE
GREENSBORO NC, 27401-1844, US
Phone (336) 273-2528
Fax (336) 273-8038
Business Location
1115 W FRIENDLY AVE
GREENSBORO NC, 27401-1844, US
Phone (336) 273-2528
Fax (336) 273-8038
Toxanomy
Taxonomy Code 1223X0400X
License State Pennsylvania
License Number 3338
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According to our database, Dr. Jerry R Clark DDS, MS NPI is 1619203551, taxonomy code is 1223X0400X and license number is 3338, license state is located at Pennsylvania. Jerry R Clark DDS, MS physically located at 1115 W Friendly Ave, Greensboro NC, 27401-1844. NPI Number Jerry R Clark DDS, MS has the Individual type.

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1619203551 NPI number is provided on an as is basis without warranty of any kind. 1619203551 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry R Clark DDS, MS are for informational purposes only.