Individual
LESLIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2460 WILLAMETTE ST, EUGENE, OR 97405-3169
(541) 453-5206
Mailing address
2460 WILLAMETTE STREET, EUGENE, OR 97405
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5315
OR
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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