Individual
MR. CHRISTOPHER J CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
877 E GANNON AVE, ZEBULON, NC 27597-9314
(919) 269-0103
(910) 863-2555
Mailing address
877 E GANNON AVE, ZEBULON, NC 27597-9314
(919) 269-0103
(910) 863-2555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7917
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901223
—
NC
Enumeration date
11/21/2006
Last updated
12/08/2008
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