# JOHN A LARK DDS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1114380094
- **Authorized official:** MRS. LINDSEY ANN MCMORDIE EFDA (OFFICE MANAGER)
- **Authorized official phone:** (517) 263-9022

## Contact information

- **Practice address:** 1136 COUNTRY CLUB RD, SUITE B, ADRIAN, MI 49221-8208
- **Practice address phone:** (517) 263-9022
- **Practice address fax:** (517) 263-9155
- **Mailing address:** 1136 COUNTRY CLUB, SUITE B, ADRIAN, MI 49221
- **Mailing address phone:** (517) 263-9022
- **Mailing address fax:** (517) 263-9155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 15006 | MI | Yes |

## Other

- **Enumeration date:** 03/30/2016
- **Last updated:** 03/30/2016