Organization
WATT AND CLARK L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN R. CLARK D.D.S. (PRESIDENT)
(703) 391-2600
Entity
Organization
Contact information
Practice address
1950 ROLAND CLARKE PL, SUITE # 420, RESTON, VA 20191-1414
(703) 391-2600
Mailing address
1950 ROLAND CLARKE PL, SUITE # 420, RESTON, VA 20191-1414
(703) 391-2600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6580
VA
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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