Individual
DR. CLARK G. DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
(708) 596-5518
Mailing address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
(708) 596-5518
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019022252
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019022252
—
IL
Enumeration date
11/08/2006
Last updated
04/27/2023
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