Individual
DR. DORRANCE D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
2425 E 12 MILE RD, WARREN, MI 48092-5667
(586) 519-5977
Mailing address
2425 E 12 MILE RD, WARREN, MI 48092-5667
(586) 519-5826
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901018485
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736499
—
AZ
05
—
736499
—
NC
01
—
AZ0479180
BLUECROSS BLUESHIELD #
AZ
Enumeration date
10/18/2006
Last updated
12/18/2025
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