# C BENSON CLARK, DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** King Centre Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134503444
- **Authorized official:** DR. CLEOPHUS BENSON CLARK DDS (DENTIST OWNER)
- **Authorized official phone:** (703) 719-9824

## Contact information

- **Practice address:** 5695 KING CENTRE DR, STE. B-100, ALEXANDRIA, VA 22315-5744
- **Practice address phone:** (703) 719-9824
- **Mailing address:** 5695 KING CENTRE DR, STE. B-100, ALEXANDRIA, VA 22315-5744
- **Mailing address phone:** (703) 719-9824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401003822 | VA | Yes |

## Other

- **Enumeration date:** 07/16/2015
- **Last updated:** 09/11/2015