Individual
DR. H. DOUGLAS CLARK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2101 HILL AVE, SUPERIOR, WI 54880-5260
(715) 392-5161
(715) 392-7474
Mailing address
2101 HILL AVE, SUPERIOR, WI 54880-5260
(715) 392-5161
(715) 392-7474
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1458G
WI
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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