Individual
DR. STEPHEN JAY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
8228 N MAIN ST, DAYTON, OH 45415-1641
(937) 454-1103
(937) 454-1140
Mailing address
8228 NORTH MAIN STREET, DAYTON, OH 45415
(937) 454-1103
(937) 454-1140
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
18886
OH
Other
Enumeration date
09/17/2007
Last updated
09/17/2007
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