Individual
DR. DAKOTA B CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1450 1ST AVE SW, JACKSONVILLE, AL 36265-3329
(256) 435-2007
(256) 435-4669
Mailing address
1450 1ST AVE SW, JACKSONVILLE, AL 36265-3329
(256) 435-2007
(256) 435-4669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6493
AL
Other
Enumeration date
06/06/2018
Last updated
10/15/2020
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