Organization
HEALTHY SMILES FAMILY & COSMETIC DENTISTRY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISTY DAWN CLARK DMD (DENTIST)
(606) 886-0300
Entity
Organization
Contact information
Practice address
83 OAK RIDGE CT, PRESTONSBURG, KY 41653-8595
(606) 886-0300
(606) 886-9334
Mailing address
83 OAK RIDGE CT, PRESTONSBURG, KY 41653-8595
(606) 886-0300
(606) 886-9334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8481
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100088720
—
KY
Enumeration date
02/06/2013
Last updated
02/06/2013
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