Individual
KATHRYN JAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4110 RIVER RD NW, WASHINGTON, DC 20016-4618
(202) 686-2108
Mailing address
4110 RIVER RD NW, WASHINGTON, DC 20016-4618
(202) 686-2108
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN1000899
DC
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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