Organization
DAVID A CLARK DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ALLEN CLARK DDS (OWNER)
(509) 966-2233
Entity
Organization
Contact information
Practice address
4209 TIETON DR STE 102, YAKIMA, WA 98908-3377
(509) 966-2230
(509) 966-8812
Mailing address
4209 TIETON DR STE 102, YAKIMA, WA 98908-3377
(509) 966-2230
(509) 966-8812
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60023580
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124194972
—
WA
05
—
1962668202
—
WA
Enumeration date
02/03/2011
Last updated
02/03/2011
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