Individual
JESSE D CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1611 GREENFIELD ST, WILMINGTON, NC 28401-6455
(910) 342-9210
(910) 342-9211
Mailing address
1611 GREENFIELD ST, WILMINGTON, NC 28401-6455
(910) 342-9210
(910) 342-9211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8520
NC
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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