Individual
DR. ALBERT BAXTER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1355 N UNIVERSITY AVE, SUITE 320, PROVO, UT 84604-2721
(801) 375-1750
(801) 375-6365
Mailing address
1355 N UNIVERSITY AVE, SUITE 320, PROVO, UT 84604-2721
(801) 375-1750
(801) 375-6365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
139191-9922
UT
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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