Individual
CLARK IZU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
20 MARYLAND, IRVINE, CA 92606-1739
(562) 544-7033
Mailing address
20 MARYLAND, IRVINE, CA 92606-1739
(562) 544-7033
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
42920
CA
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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