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Organization
JEFFREY CLARK
Active
Organization
JEFFREY CLARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY B CLARK DDS (OWNER)
(785) 273-2565
Entity
Organization
Contact information
Practice address
5990 SW 28TH ST, SUITE D, TOPEKA, KS 66614-2545
(785) 273-2565
(785) 273-2567
Mailing address
5990 SW 28TH ST., SUITE D, TOPEKA, KS 66614-3525
(785) 273-2565
(785) 273-2567
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60087
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116611
BLUE CROSS
KS
Enumeration date
03/07/2007
Last updated
08/22/2020
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