Individual
DR. ROBERT JOSEPH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5323 BRAINERD RD STE 105, CHATTANOOGA, TN 37411-5305
(423) 485-1000
(423) 485-1233
Mailing address
5323 BRAINERD RD STE 105, CHATTANOOGA, TN 37411-5305
(423) 485-1000
(423) 485-1233
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
TNDS002676
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003061
BLUE CROSS BLUE SHIELD
TN
Enumeration date
04/02/2007
Last updated
07/08/2007
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