Organization
KENDALL IMPLANT AND ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES LEE CLARK DDS (OWNER)
(830) 331-2007
Entity
Organization
Contact information
Practice address
109 FALLS CT STE 700, BOERNE, TX 78006-2984
(830) 331-2007
(830) 331-2009
Mailing address
109 FALLS CT STE 700, BOERNE, TX 78006-2984
(830) 331-2007
(830) 331-2009
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/17/2020
Last updated
04/17/2020
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