Individual
DR. CANDICE ELLA CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
506 AIRPORT DR, FARMINGTON, NM 87401-2602
(505) 325-7700
(505) 327-5710
Mailing address
530 N TELSHOR BLVD, SUITE A, LAS CRUCES, NM 88011-8243
(505) 532-5437
(505) 522-4138
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2673
NM
Other
Enumeration date
10/27/2005
Last updated
07/08/2007
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