Individual
JEFFREY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5709 NW RADIAL HWY, OMAHA, NE 68104-4141
(402) 551-1757
Mailing address
5709 NW RADIAL HWY, OMAHA, NE 68104-4141
(402) 551-1757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12-2006
NM
1223G0001X
General Practice Dentistry
Primary
7262
NE
Other
Enumeration date
02/06/2007
Last updated
05/10/2026
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