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Individual
ALEXANDER CLARK
Active
Individual
ALEXANDER CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61486
KS
1223G0001X
General Practice Dentistry
2016001210
MO
Other
Enumeration date
06/21/2016
Last updated
05/12/2022
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