Organization
DONALD E. CLARKE, D.D.S., INC.
Active
Other names
Dental Source of California
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD CLARKE DDS (PRESIDENT OF CORPORATION)
(916) 487-0117
Entity
Organization
Contact information
Practice address
25005 BLUE RAVINE RD STE 100, FOLSOM, CA 95630-5706
(916) 600-3719
Mailing address
3901 MARCONI AVE, SACRAMENTO, CA 95821-3902
(916) 487-0117
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
05/16/2022
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