# HEATHER M. CLARK D.M.D PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063612224
- **Authorized official:** JENNY HERNANDEZ (ASSISTANT OFFICE MANAGER)
- **Authorized official phone:** (609) 646-2501

## Contact information

- **Practice address:** 2311 NEW RD, NORTHFIELD, NJ 08225-1442
- **Practice address phone:** (609) 646-2501
- **Practice address fax:** (609) 646-0151
- **Mailing address:** 2311 NEW RD, NORTHFIELD, NJ 08225-1442
- **Mailing address phone:** (609) 646-2501
- **Mailing address fax:** (609) 646-0151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DI20003 | NJ | Yes |

## Other

- **Enumeration date:** 07/24/2007
- **Last updated:** 07/24/2007