Organization
CHRISTOPHER CLARK DDS PA
Active
Other names
Bladenboro Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J CLARK DDS (OWNER)
(910) 863-2377
Entity
Organization
Contact information
Practice address
104 FOURTH ST, BLADENBORO, NC 28320
(910) 863-2377
(910) 863-2555
Mailing address
104 FOURTH ST, BLADENBORO, NC 28320
(910) 863-2377
(910) 863-2555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7917
NC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
8366
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903289
—
NC
Enumeration date
04/24/2008
Last updated
04/24/2008
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