Individual
DR. ANNIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 PETERS CREEK PKWY, WINSTON SALEM, NC 27127-3726
(336) 955-1379
Mailing address
PO BOX 592, PORT GIBSON, MS 39150-0592
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12763
NC
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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