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Individual

DR. WARD WILLIAM CLEMMONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., P.A.

Contact information

Practice address
3600 OLD GREENWOOD RD, SUITE 2, FORT SMITH, AR 72903-5929
(479) 434-6894
(479) 434-6896
Mailing address
3600 OLD GREENWOOD RD, SUITE 2, FORT SMITH, AR 72903-5929
(479) 434-6894
(479) 434-6896

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2820
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121451608
AR
05
175067
OK
01
2820
LICENSE #
AR
01
71-0751372
TAX ID #
AR
Enumeration date
09/13/2006
Last updated
07/31/2013
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