Individual
CHRISTOPHER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
60 MARKET CENTER DR, COLLIERVILLE, TN 38017-7077
(901) 850-7338
Mailing address
PO BOX 257, CARROLLTON, MS 38917-0257
(901) 484-9001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11067
TN
1223G0001X
General Practice Dentistry
4050-19
MS
Other
Enumeration date
06/05/2019
Last updated
06/11/2019
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