Organization
CLARK ORAL & FACIAL SURGERY - BURLEY
Active
Parent organization
CLARK ORAL & FACIAL SURGERY - BURLEY
Other names
Clark Oral & Facial Surgery, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLARK ORAL & FACIAL SURGERY - BURLEY
Authorized official
MRS. DURELLA DEE HOLMES (PRACTICE MANAGER)
(208) 831-2900
Entity
Organization
Contact information
Practice address
1404 POMERELLE AVE STE A2, BURLEY, ID 83318-2013
(208) 831-2901
(208) 736-6249
Mailing address
1404 POMERELLE AVE STE A2, BURLEY, ID 83318-2013
(208) 831-2901
(208) 736-6249
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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