Individual
TYLER DUANE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
27 W 17TH AVE, EUGENE, OR 97401-4012
(541) 344-0413
Mailing address
27 W 17TH AVE, EUGENE, OR 97401-4012
(541) 344-0413
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9605
OR
Other
Enumeration date
08/01/2011
Last updated
08/01/2011
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