# JEFFREY CLARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1407995426
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12-2006 | NM | Yes |
| 1223G0001X | General Practice Dentistry | 7262 | NE | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 05/10/2026