Individual
DR. GREGORY DALE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4212 MCEVER RD, OAKWOOD, GA 30566-2237
(770) 534-1816
(770) 534-3059
Mailing address
4212 MCEVER ROAD, OAKWOOD, GA 30566
(770) 534-4663
(770) 534-3059
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8846
GA
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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