Individual
THOMAS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
29292 SW TOWN CENTER LOOP E, WILSONVILLE, OR 97070-9491
(506) 682-0431
(503) 682-3873
Mailing address
29292 SW TOWN CENTER LOOP E, WILSONVILLE, OR 97070-9491
(506) 682-0431
(503) 682-3873
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9460
OR
Other
Enumeration date
07/16/2010
Last updated
12/17/2013
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