Individual
ERIC CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2110 N FOUNTAIN GREEN RD, BEL AIR, MD 21015-1414
(410) 628-0920
Mailing address
2110 N FOUNTAIN GREEN RD, BEL AIR, MD 21015-1414
(410) 628-0920
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17754
MD
1223G0001X
General Practice Dentistry
17754
MD
1223G0001X
General Practice Dentistry
DS042051
PA
Other
Enumeration date
05/13/2019
Last updated
05/28/2025
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