Organization
CLARK ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW CLARK (PRESIDENT)
(850) 385-2822
Entity
Organization
Contact information
Practice address
5555 ROANOKE TRL, TALLAHASSEE, FL 32312-4868
(850) 385-2822
Mailing address
5555 ROANOKE TRL, TALLAHASSEE, FL 32312-4868
(850) 385-2822
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19032
FL
Other
Enumeration date
02/16/2015
Last updated
02/16/2015
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