Individual
DR. MARK CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
301 W. GRAYSON ST., GALAX, VA 24333-2813
(276) 236-6321
Mailing address
301 W. GRAYSON ST., GALAX, VA 24333-2813
(276) 236-6321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
VA0401005863
VA
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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