# DR. DAVID MICHAEL CLARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1619919685
- **Gender:** Man
- **Credential:** D.M.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 046057-1 | NY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DA 026947 A | PA | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS 026947 L | PA | — |

## Other

- **Enumeration date:** 06/12/2006
- **Last updated:** 01/07/2016