Individual
DENNIS WILLARD CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
90 MARKET ST, SUITE 80, LEBANON, OR 97355-2394
(541) 451-1440
(541) 451-1507
Mailing address
90 MARKET ST, SUITE 80, LEBANON, OR 97355-2394
(541) 451-1440
(541) 451-1507
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5507
OR
Other
Enumeration date
07/15/2005
Last updated
07/08/2007
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