Individual
DR. JENNIFER MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3666 N MILLER RD STE 109, SCOTTSDALE, AZ 85251-4534
(480) 994-9485
(480) 481-3800
Mailing address
3666 N. MILLER SUITE 109, SCOTTSDALE, AZ 85251
(480) 994-9485
(480) 481-3800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5498
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
619934
AHCCCS
AZ
Enumeration date
09/02/2006
Last updated
05/07/2012
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