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Individual
DR. DORRANCE D CLARK
Active
Individual
DR. DORRANCE D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901018485
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736499
—
AZ
05
—
736499
—
NC
01
—
AZ0479180
BLUECROSS BLUESHIELD #
AZ
Enumeration date
10/18/2006
Last updated
12/18/2025
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