Individual
DR. JACK R CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1856 LANCASTER RD, HOMEWOOD, AL 35209-4114
(205) 871-2591
(205) 879-1900
Mailing address
1856 LANCASTER RD, HOMEWOOD, AL 35209-4114
(205) 871-2591
(205) 879-1900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4290
AL
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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