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Organization
MAXINE V. CLARK. D.D.S., P.A.
Active
Organization
MAXINE V. CLARK. D.D.S., P.A.
Active
Other names
Maryland Orthodontic Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAXINE VILLIERS CLARK D.D.S. (CEO)
(410) 719-0480
Entity
Organization
Contact information
Practice address
2 E ROLLING CROSSROADS, SUITE 257, CATONSVILLE, MD 21228-6211
(410) 719-0480
(410) 747-3135
Mailing address
2 E ROLLING CROSSROADS, SUITE 257, CATONSVILLE, MD 21228-6211
(410) 719-0480
(410) 747-3135
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8300
MD
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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