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Individual

DR. JOSEPH R CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
42 GEORGIA AVE, COMMERCE, GA 30529-2320
(706) 335-4699
Mailing address
42 GEORGIA AVE, COMMERCE, GA 30529-2320
(706) 335-4699

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN009715
GA
1223G0001X
General Practice Dentistry
Primary
DN009715
GA

Other

Enumeration date
11/30/2010
Last updated
11/30/2010
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