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Individual

ALEXANDER CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
8340 MISSION RD STE 118, PRAIRIE VILLAGE, KS 66206-1362
(913) 362-4488
Mailing address
8340 MISSION RD STE 118, PRAIRIE VILLAGE, KS 66206-1362
(913) 362-4488

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61486
KS
1223G0001X
General Practice Dentistry
2016001210
MO

Other

Enumeration date
06/21/2016
Last updated
05/12/2022
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