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Organization
CLARKE L SHORT DDS LLC
Active
Organization
CLARKE L SHORT DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARKE SHORT (DENTIST)
(801) 850-7280
Entity
Organization
Contact information
Practice address
347 WEST IDAHO AVENUE, ONTARIO, OR 97914-9791
(541) 889-8837
(541) 889-8991
Mailing address
347 W IDAHO AVE, ONTARIO, OR 97914-2344
(541) 889-8837
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10763
OR
Other
Enumeration date
02/08/2018
Last updated
02/08/2018
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