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Individual

DR. JAMES A CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD,MS

Contact information

Practice address
3650 LAKE OTIS PKWY, SUITE 201, ANCHORAGE, AK 99508-5207
(907) 561-1430
(907) 561-2697
Mailing address
3650 LAKE OTIS PKWY, SUITE 201, ANCHORAGE, AK 99508-5207
(907) 561-1430
(907) 561-2697

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
389
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
831476
TRI-CARE ID
AK
05
DD0389
AK
Enumeration date
07/28/2006
Last updated
07/09/2007
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