Individual
DR. MATTHEW MITCHELL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
716 DENBIGH BLVD STE C1, NEWPORT NEWS, VA 23608-4414
(757) 874-6501
Mailing address
101 ZACHARY PL, YORKTOWN, VA 23693-1909
(865) 266-3026
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401417451
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
10945
TN
Other
Enumeration date
02/11/2016
Last updated
02/02/2025
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