Individual
RDEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
575 EAST UNIVERSITY PARKWAY, SUITE A24, OREM, UT 84058
(801) 225-3300
Mailing address
575 EAST UNIVERSITY PARKWAY, SUITE A24, OREM, UT 84058
(801) 225-3300
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
Y76242
UT
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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