Individual
DR. RODNEY KEITH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1918 FORSYTH STREET, MACON, GA 31201
(478) 746-0046
Mailing address
1918 FORSYTH STREET, MACON, GA 31201
(478) 746-0046
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12507
GA
Other
Enumeration date
04/26/2007
Last updated
09/05/2008
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