Organization
C BENSON CLARK, DDS, PC
Active
Other names
King Centre Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLEOPHUS BENSON CLARK DDS (DENTIST OWNER)
(703) 719-9824
Entity
Organization
Contact information
Practice address
5695 KING CENTRE DR, STE. B-100, ALEXANDRIA, VA 22315-5744
(703) 719-9824
Mailing address
5695 KING CENTRE DR, STE. B-100, ALEXANDRIA, VA 22315-5744
(703) 719-9824
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401003822
VA
Other
Enumeration date
07/16/2015
Last updated
09/11/2015
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