# W.A. CLARK, D.D.S., P.L.L.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Clark Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740521509
- **Authorized official:** DR. WALEED AJAMU CLARK DDS (OWNER)
- **Authorized official phone:** (202) 271-3096

## Contact information

- **Practice address:** 1040 NE 36TH ST, OKLAHOMA CITY, OK 73111-5002
- **Practice address phone:** (405) 427-5405
- **Mailing address:** 612 BELLEMEADE ST, GREENSBORO, NC 27401-1903
- **Mailing address phone:** (202) 271-3096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6354 | OK | Yes |

## Other

- **Enumeration date:** 03/04/2013
- **Last updated:** 03/04/2013