Individual
DR. SAMANTHA ALEXANDRIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5 4TH AVE. E., POLSON, MT 59860
(406) 745-3525
(406) 745-3529
Mailing address
P.O. BOX 880, ST. IGNATIUS, MT 59865
(406) 745-3525
(406) 745-3529
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12012102A
IN
1223P0221X
Pediatric Dentistry
390200000
IN
Other
Enumeration date
04/19/2013
Last updated
09/10/2015
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