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Organization
CLARK ORAL SURGERY AND IMPLANT CENTER
Active
Organization
CLARK ORAL SURGERY AND IMPLANT CENTER
Active
Other names
Dr. Tyler L. Clark
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ESTHER MASTRANDREA (OFFICE MANAGER)
(503) 245-1100
Entity
Organization
Contact information
Practice address
9430 SW CORAL ST STE 200, TIGARD, OR 97223-6692
(503) 245-1100
(503) 473-8300
Mailing address
9430 SW CORAL ST STE 200, TIGARD, OR 97223-6692
(503) 245-1100
(503) 473-8300
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D10177
OR
Other
Enumeration date
06/20/2017
Last updated
07/21/2022
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