# ADAM D. CLOCK, D.D.S., L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tipton Park Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265662217
- **Authorized official:** DR. ADAM DOUGLAS CLOCK D.D.S. (OWNER/PRESIDENT/MEMBER)
- **Authorized official phone:** (812) 376-9335

## Contact information

- **Practice address:** 530 PLAZA DR STE J, COLUMBUS, IN 47201-2940
- **Practice address phone:** (812) 376-9335
- **Practice address fax:** (812) 376-9298
- **Mailing address:** 530 PLAZA DR STE J, COLUMBUS, IN 47201-2940
- **Mailing address phone:** (812) 376-9335
- **Mailing address fax:** (812) 376-9298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010542A | IN | Yes |

## Other

- **Enumeration date:** 07/23/2009
- **Last updated:** 07/23/2009