Individual
DR. DWIGHT EUGENE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
11216 TRINITY RIVER DRIVE, RANCHO CORDOVA, CA 95670
(916) 635-6161
(916) 631-3788
Mailing address
11216 TRINITY RIVER DRIVE, RANCHO CORDOVA, CA 95670
(916) 635-6161
(916) 631-3788
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5512
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0055120
—
CA
Enumeration date
08/31/2006
Last updated
11/28/2011
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